434410805-7-21-2022-52-CC-EWOS-CGJUE9-20220721153045

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410805
Report Date: 07/21/2022
Date Signed: 07/21/2022 03:30:52 PM

Document Has Been Signed on 07/21/2022 03:30 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	T'ENNA PRESCHOOL AT THE OSHMAN FAMILY JCC		FACILITY NUMBER:	434410805
ADMINISTRATOR:	MYKENZIE BUSSER		FACILITY TYPE:	850
ADDRESS:	3921 FABIAN WAY		TELEPHONE:	(650) 223-8788
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94303
CAPACITY:	250	CENSUS: 69	DATE:	07/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Lauren Berman		TIME COMPLETED:	03:45 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 July 21, 2022 at 11:45 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced 1 Year Required Inspection and met with the facility representative, Lauren Berman. LPA disclosed the purpose of the inspection and was granted entry into the facility by the representative. There were sixty nine (69) children present during this inspection and seventeen (17) additional staff members. The facility consists of fourteen (14) classrooms. The facility was toured for a health and safety inspection. The hours of operation are 9:00 AM-4:00 PM, Monday -Friday CLASSROOMS: The classrooms were inspected at 12:30 PM and teacher child ratio was observed. There are adequate play and learning materials available and the floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The center is equipped with a working telephone, wired smoke/carbon monoxide detectors, pull down fire alarm, and sprinkler system in every classroom. Each room has fully charged 3A40BC fire extinguisher and all solid waste storage containers have tight fitting covers on, and appear to be in good repair. ISOLATION: The isolation area for sick children is outside the office next to the entrance gate. BATHROOMS AND TOILETING AREAS: There are separate bathrooms for staff and children. Toilets and faucets are in safe and sanitary operating condition. The children are able to reach the sinks and toilets. Supplies are available to the children. Changing tables are next to the faucets in the bathroom. See 809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: T'ENNA PRESCHOOL AT THE OSHMAN FAMILY JCC	FACILITY NUMBER: 434410805
	VISIT DATE: 07/21/2022

NARRATIVE

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FOOD SERVICE AREAS: The facility provides snacks for the children and the parents provide lunch for their children. The snack menus are posted at least one week in advance, available for review and dated. LPA observed the kitchen/food preparation and storage areas to be clean and free of evidence of rodents. Pesticides and other similar toxic substances are not stored in cabinets that contains food. Most classrooms have refrigerators and stoves.

OUTDOOR PLAY AREAS: There are no bodies of water, or free standing water accessible to children. There are age appropriate toys and materials for the children. The outdoor space for toddlers are physically separate from preschoolers. There’s a shaded rest area for children, multiple gardens, and a sand boxes areas. The playground is fenced and all equipment and surfaces are safe and free from hazards. There are play structures for climbing and sliding that are anchored with cushioning underneath to absorb falls.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Twelve (12) children's files and six (6) staff files were reviewed at 1:00 PM. All children files have Identification & Emergency, Personal Rights, and Medical Consent forms and all staff files have required Health Screening, Criminal Records Statements, and Employee Rights. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed and certificates were reviewed. Director's CPR and First Aid certificate is current and expires on 05/2023. The center is in compliance with the sign in and out procedure. Disaster drills are being conducted at least once every 6 months and the log indicates the last one conducted was on 05/19/2022. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: IMS is being provided at this facility. LPA inspected the medication, which is stored in a safe place that is inaccessible to children in care. Each of the medications has an unaltered label with the child’s name and date of issuance. The center is equipped with fully stocked first aid kits that are available in the classrooms.

See 809-C.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: T'ENNA PRESCHOOL AT THE OSHMAN FAMILY JCC	FACILITY NUMBER: 434410805
	VISIT DATE: 07/21/2022

NARRATIVE

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California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following 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

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Facility representative 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.

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.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Lauren Berman.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC809 (FAS) - (06/04)

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