434408838-1-19-2023-52-CC-MMAW-CN8SKT-20230119125717

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408838
Report Date: 01/19/2023
Date Signed: 01/19/2023 12:57:29 PM

Document Has Been Signed on 01/19/2023 12:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	HOPE TECHNOLOGY SCHOOL - PRESCHOOL PROGRAM		FACILITY NUMBER:	434408838
ADMINISTRATOR:	GARCIA,L&BODZIOCH,K		FACILITY TYPE:	850
ADDRESS:	2525 EAST BAYSHORE ROAD		TELEPHONE:	(650) 565-8391
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94303
CAPACITY:	16	CENSUS: 5	DATE:	01/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Kristi Bodzioch		TIME COMPLETED:	01:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 1/19/23 at 9:35 AM Licensing Program Analyst (LPA) Michael Mathew conducted an unannounced Annual/Random inspection. LPA conducted the Covid-19 screening questions prior to entering the facility. LPA met with director Kristi Bodzioch advised her the purpose of the inspection. LPA was provided a tour of the facility inside and out. There were 5 children in care and 3 staff at the time of the inspection. LPA observed required licensing documents mounted on the walls throughout the facility. Director stated that lunch and snack are brought from home. Fire drill was last conducted on 11/9/22. The center has one (1) classroom available. At the time of inspection, 1 classroom was in use. LPA observed enough restrooms available for children in care. LPA did not observe any hazards/toxins items accessible to children in care. There are no guns/weapons or ammunition at the facility. LPA observed no bodies of water. Each of the classrooms have age-appropriate toys and furniture readily accessible for children. Facility provides children sleeping cots during nap time. The outdoor playground has ample amount of space for children to play. LPA observed a rubber padding under the play structure to help protect the children when they fall. LPA observed the playground has age-appropriate toys and structures available for children to use. The playground has an ample amount of shade available. Facility provides water, and the children have water bottles with their names on it for use. A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. Currently the facility does have children that require Incidental Medical services (IMS). LPA observed IMS is kept above the sink inaccessible to children in care. LPA observed correct licensing form in children file. LPA observed staff files to be incomplete. LPA observed all staff members did not have the approved mandated reporter training certificate. LPA observed all staff members with a valid CPR/first aid certificate. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. LPA spoke with director about new Covid-19 guidelines. Continue 809-C

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: 510-292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: HOPE TECHNOLOGY SCHOOL - PRESCHOOL PROGRAM	FACILITY NUMBER: 434408838
	VISIT DATE: 01/19/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation interpretations and procedures for Child Care Centers sections 101173 and 101226. When any IMS is provided, an updated plan of operation that includes IMS must be submitted to the Department. the follow information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA information line at (800) 514-0301 (voice) / (800) 514-0383 (TTY) and link to publication: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

PIN 22-06-CCP: Lead Testing in Child Care Centers – Frequently Asked Questions and Information on Lead Toxicity Prevention and Water Testing Information was discussed to director Kristi Bodzioch

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

no deficiencies was cited in today's visit

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights were given, and report was reviewed with director Kristi Bodzioch

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: 510-292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

LIC809 (FAS) - (06/04)

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