434412158-3-17-2022-52-CC-JWIS-CCM2FB-20220317172115

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412158
Report Date: 03/17/2022
Date Signed: 03/17/2022 05:21:47 PM

Document Has Been Signed on 03/17/2022 05:21 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:	PALO ALTO PRESCHOOL BILINGUAL MONTESSORI		FACILITY NUMBER:	434412158
ADMINISTRATOR:	PULDA, VIRGINIA		FACILITY TYPE:	850
ADDRESS:	4232 EL CAMINO REAL		TELEPHONE:	(650) 739-0137
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	118	CENSUS: 84	DATE:	03/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Weijia Cai		TIME COMPLETED:	05:19 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 03/17/2022, Licensing Program Analyst (LPA) Jonathan Williams arrived at the facility unannounced for the purposes of conducting a Required 1-Year Inspection. LPA was met by Weijia Cai. Cai, referred to in this report as "Facility Representative" is a fully qualified teacher temporarily filling in for Director (Virginia Pulda). Present for this inspection are Facility Representative, 10 fingerprint cleared and associated staff members, and 84 preschool aged children in care. Facility operating hours are 8:00am-6:00pm M-F. The facility was toured to conduct a health and safety inspection. At 12:40pm, LPA toured the facility classrooms. The facility consists of four classrooms and outdoor play area. The classrooms are tidy and clean with heating and ventilation for safety and comfort. There are safe age-appropriate toys and learning materials available to children throughout the classrooms. All hazardous materials and toxins including disinfectants and cleaning solutions were observed to be made inaccessible to children during today's inspection. Furniture accessible to children was observed to be age-appropriate, in operable condition, and free of loose, sharp, or pointed parts. At 12:52pm, LPA toured the food preparation area. Food is properly stored and Facility Representative stated that contaminated food is discarded immediately. Food preparation area is kept inaccessible to children via locked door and visual supervision. At 01:15pm, LPA toured the outdoor play area. High climbing equipment is present in the outdoor play area. Cushioning material is present in sufficient quantities to absorb falls at the time of this inspection. Outdoor play area is fenced and has a shaded area. There are no pools, hot tubs, ponds, or any other bodies of water accessible to children during today's inspection. Uncontaminated drinking water is present in the outdoor play area for children to drink upon request.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan Williams	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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: PALO ALTO PRESCHOOL BILINGUAL MONTESSORI	FACILITY NUMBER: 434412158
	VISIT DATE: 03/17/2022

NARRATIVE

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The facility has multiple fully charged 3A40BC fire extinguishers, working carbon monoxide detector, working smoke detector, and working telephone. Smoke detector is wired to notify fire department when triggered, and is serviced regularly (current certification valid until 5/10/2022). At least one staff member has current CPR/1st Aid certificate. Children's files and staff files were reviewed for proper documentation. All required forms are posted in public view, including menus. Daily activity schedule is present in facility. Facility roster was obtained.

Incidental Medical Services (IMS) policy was discussed. This facility does not provide IMS to children in care at this time. 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.”

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.

Facility Representative was reminded that California Law requires licensed Child Care Centers 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. LPA informed the Facility Representative that all forms can be downloaded at www.ccld.ca.gov and encouraged the Facility Representative to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Facility Representative was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan Williams	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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: PALO ALTO PRESCHOOL BILINGUAL MONTESSORI	FACILITY NUMBER: 434412158
	VISIT DATE: 03/17/2022

NARRATIVE

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LPA discussed the safe sleep regulations with Facility Representative and discussed the Child Care Licensing Safe Sleep webpage 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.

There are no deficiencies cited. 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. Appeal rights were provided to the Facility Representative and the signature on this form acknowledges receipt of these rights.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan Williams	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

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