434413367-8-8-2022-52-CC-EWOS-CH4NWW-20220808105014

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413367
Report Date: 08/08/2022
Date Signed: 08/08/2022 10:50:23 AM

Document Has Been Signed on 08/08/2022 10:50 AM - 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:	ST. ELIZABETH SETON LITTLE SAINTS PRESCHOOL		FACILITY NUMBER:	434413367
ADMINISTRATOR:	SURITA, CRYSTAL		FACILITY TYPE:	850
ADDRESS:	1095 CHANNING AVENUE		TELEPHONE:	(650) 326-9004
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94301
CAPACITY:	30	CENSUS: 0	DATE:	08/08/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Crystal Surita		TIME COMPLETED:	11:15 AM

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 August 8, 2022 at 8:45 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced Annual Required Inspection and met with the facility representative, Crystal Surita. LPA disclosed the purpose of the inspection and was granted entry into the facility by the representative. There were no children present during this inspection and one (1) additional staff member. The facility operates in one (1) pre-k classroom located on the site of St. Elizabeth Seton Elementary School. The facility was toured for a health and safety inspection. The hours of operation are 7:30 AM-5:00 PM, Monday -Friday CLASSROOMS: The one (1) classroom was inspected and teacher child ratio was observed. There are adequate play and learning materials available. 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 isolation area for sick children is in the nurses office, away from other children in care. The center has a dual working smoke and carbon monoxide detectors, working telephone, pull down fire alarm system, first aide kit, and a fully charged 3A40BC fire extinguisher. Fire alarm/smoke detectors are configured to notify the fire department if triggered (shared system with elementary school). Director stated that fire alarm/smoke detector are serviced regularly. BATHROOMS AND TOILETING AREAS: The staff's bathroom is separate from the children's bathroom. All sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets. LPA observed adequate amounts of hand soap and paper towels in the bathrooms during this inspection. Supplies are available to the children. FOOD SERVICE AREAS: This facility provides breakfast, lunch, snacks for the children. There are weekly menus posted at the facility. Lunch is provided by the Lunch Masters and the parents order through an app. Food is protected from contamination and, per staff, contaminated food is discarded immediately. Food and beverages capable of rapid spoiling are properly stored. Pesticides and other similar toxic substances are not stored in cabinets that contains food. All storage containers for solid waste have tight fitting covers that are in good repair. 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: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

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: ST. ELIZABETH SETON LITTLE SAINTS PRESCHOOL	FACILITY NUMBER: 434413367
	VISIT DATE: 08/08/2022

NARRATIVE

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OUTDOOR PLAY AREAS: At 10:00 AM, LPA toured the outdoor play areas. There's a small slide structure with cushioning to absorb falls on the yard right outside on the classroom. There's also an additional play areas that the center shares with the school at separate times of the day. There’s a water table with cups to keep the children hydrated and trees that provide shade while children are at play.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. no children's files and one (1) staff file was reviewed around 11:00 AM. All staff files have required Health screening, Employee Rights, and Criminal Record Statements. 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 8/2023. The center is in compliance with the sign in and out procedure. Disaster drills are being conducted at least once every 6 months in conjunction with the Palo Alto Unified School District schedule. All required documents are posted in a public accessible areas.

HEALTH RELATED SERVICES: There's no IMS being provided at this time and no medication being stored at the facility. The center is equipped with a fully stocked first aid kit that is available in the classroom.

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.

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.

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: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

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: ST. ELIZABETH SETON LITTLE SAINTS PRESCHOOL	FACILITY NUMBER: 434413367
	VISIT DATE: 08/08/2022

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 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

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.

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.

There are no deficiency 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, Crystal Surita.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

LIC809 (FAS) - (06/04)

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