434415330-9-16-2021-52-CC-MOTI-C6WUQG-20210916154706

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415330
Report Date: 09/16/2021
Date Signed: 09/16/2021 03:47:15 PM

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:	STOCK FARM ROAD CHILDREN'S CENTER		FACILITY NUMBER:	434415330
ADMINISTRATOR:	PHEISTER, REBECCA		FACILITY TYPE:	830
ADDRESS:	183 STOCK FARM ROAD		TELEPHONE:	(650) 736-8465
CITY:	STANFORD	STATE: CA	ZIP CODE:	94305
CAPACITY:	48	CENSUS: 24	DATE:	09/16/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:01 AM
MET WITH:	Ollia Yenikomshian & Rebecca Pheister		TIME COMPLETED:	04:05 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	Licensing Program Analyst (LPA) Melanie Otsuji conducted an unannounced Case Management - Licensee initiated inspection on today's date, 9/16/2021. LPA was met by Director, Ollia Yenikomshian and Assistant Director, Rebecca Pheister. Present during today's visit were 24 infant aged children and 9 staff members. The center has submitted an application for a CAPACITY INCREASE to add a TODDLER OPTION to the INFANT COMPONENT. Also on site is a preschool component (CAPACITY 76) operating out of 5 rooms (Chicken Little, Sheep in a Jeep, Peter Rabbit, Red Hen, and 5 Ducks). INFANT COMPONENT is currently requesting to increase from 48 infants to 64 infants, which includes up to 24 toddlers in the toddler option program in 2 rooms (Pokey Little Puppy and Pat the Pony). A health and safety inspection was conducted inside and outside. Facility days and hours of operation are Monday through Friday 6:30AM - 6:30PM. The facility measurement was completed on a previous visit and measurements are follows: INDOORS: 2429.12 SQUARE FEET = 69 CHILDREN OUTDOORS: 3850.66 SQUARE FEET = 51 CHILDREN The center has obtained an approved fire clearance from Santa Clara County Fire Department for 140 children which includes 76 preschoolers, and 64 infants, which includes up to 24 toddlers. Stock Farm Road Children's Center Infant Component will have 5 approved classrooms (Peek a Moo, Mary Had a Little Lamb, 3 Little Pigs, Pokey Little Puppy (Toddler) and Pat the Pony(Toddler)) . Facility will also have 3 play yards available for the infant/toddlers (Infant/Toddler Play yard, Infant Play yard and Toddler Garden/Breezeway). The infant rooms are equipped with varied age appropriate materials and equipment. There are 2 toilets, and 6 sinks available for children use. Potty chairs will be made available for Pat the Pony classroom. The staff have a separate bathroom in which will also serve as an isolation bathroom.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021

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: STOCK FARM ROAD CHILDREN'S CENTER	FACILITY NUMBER: 434415330
	VISIT DATE: 09/16/2021

NARRATIVE

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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

All licensing required documents are posted. Zero Tolerance policies were explained. Notice of Site Visit form was provided and posted. The center was found to be clean, safe, sanitary and in good repair. There were no deficiencies cited during this visit.

A license for 64 infant aged children operating out of Peek a Moo, Mary Had a Little Lamb, 3 Little Pigs which includes up to 24 toddlers operating in rooms Pokey Little Puppy and Pat the Pony will be issued today, effective 9/16/2021.

An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021

LIC809 (FAS) - (06/04)

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