434412740-10-2-2023-52-CC-MMAW-CURRQ4-20230816131255

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412740
Report Date: 08/16/2023
Date Signed: 10/02/2023 02:36:53 PM

Document Has Been Signed on 10/02/2023 02:36 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:	CORNERSTONE MANDARIN CHINESE IMMERSION SCHOOL		FACILITY NUMBER:	434412740
ADMINISTRATOR:	PUI HUNG HELEN WONG		FACILITY TYPE:	850
ADDRESS:	4243 MANUELA AVENUE		TELEPHONE:	(650) 215-0208
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	30	CENSUS: 22	DATE:	08/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:31 AM
MET WITH:	Helen Wong		TIME COMPLETED:	01:30 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 8/16/23 at 9:10 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 Helen Wong and advised her the purpose of the inspection. LPA was provided a tour of the facility inside and out. There were 20 children in care and 5 staff at the time of the inspection. LPA observed required licensing documents mounted on the walls throughout the facility. Director stated that snacks and lunches are brought from the childs home. Fire drill was last conducted on 5/15/23. The center has three (3) classrooms available. At the time of inspection, 2 classrooms were 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 tan bark 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 not have children that require Incidental Medical services (IMS). LPA observed staff files to be in complete. LPA observed all staff member with a valid Mandated reporter certificate. LPA observed at least one staff member with a valid CPR/first aid certificate. LPA observed a staff who is an intern (S1) present and caring for children at the facility. S1 has not been fingerprint cleared to work at the facility. director stated S1 has been working at the facility since 8/10/23. LPA reviewed S1 file and guardian and did not see any clearance letter. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. LPA spoke with director about new Covid-19 guidelines. Continued 809-C.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: 510-292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

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: CORNERSTONE MANDARIN CHINESE IMMERSION SCHOOL	FACILITY NUMBER: 434412740
	VISIT DATE: 08/16/2023

NARRATIVE

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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/inspection-process.

Director was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed the safe sleep regulations with licensee 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 licensee 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.

LPA Mathew informed director Helen Wong that this report dated 8/16/23 document One Type A citation and should be posted for 30 consecutive days. LPA Mathew informed the Director Helen Wong provide a copy of this licensing report dated 8/16/23 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

One Type A deficiency was cited during today's inspection. A civil penalty of $500 has been assessed.

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 and report was reviewed with Director Helen Wong

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: 510-292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/02/2023 02:36 PM - It Cannot Be Edited

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: CORNERSTONE MANDARIN CHINESE IMMERSION SCHOOL	FACILITY NUMBER: 434412740
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101170(e)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. LPA observed a staff who is an intern (S1) present and caring for children at the facility. S1 has not been fingerprint cleared to work at the facility. director stated S1 has been working at the facility since 8/10/23.
	POC Due Date: 08/30/2023
	Plan of Correction
1 2 3 4	Director agreed that S1 will not be at the facility until S1 is cleared. Director will submit a written plan on how to prevent a similar occurrence in the future. Written plan must be submitted by end of day Wednesday 8/30/23

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: 510-292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC809 (FAS) - (06/04)

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