435700740-6-16-2021-52-CC-MOTI-C42S3J-20210616133109

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700740
Report Date: 06/16/2021
Date Signed: 06/16/2021 01:31:19 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:	BUILDING KIDZ SCHOOL		FACILITY NUMBER:	435700740
ADMINISTRATOR:	GILL, DIBJOT		FACILITY TYPE:	850
ADDRESS:	569 SAN ANTONIO ROAD		TELEPHONE:	(408) 515-8628
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	55	CENSUS: 12	DATE:	06/16/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Dibjot Gill		TIME COMPLETED:	01:50 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	A Prelicensing inspection was conducted today 6/16/2021 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met with Applicant, Dibjot Gill. The applicant has submitted an application for a CHANGE in OWNERSHIP preschool license for 55 preschoolers including up to 10 toddlers in the toddler option program. The program will operate from 7:00AM - 6:00PM temporarily hours are 8:00-5:30PM, Monday through Friday, in 5 classrooms. Toddler Room will serve the toddler option program with up to 10 toddlers. Present during today's visit were 4 staff members and 12 children. A health and safety inspection was conducted inside and outside and the measurements are as follows: INDOORS: 2684.07 square feet = 77 children OUTDOORS: 14856.35 square feet = 198 children The center has obtained an approved fire inspection clearance from the Palo Alto Fire Department on 6/11/2021. The preschool rooms are equipped with varied age appropriate materials and equipment. There are 6 toilets and 8 sinks available for children. Staff toilet is located in the kitchen/break room area. The kitchen is located across from play yard 4. Children bring their lunch from home. Facility will provide AM/PM snacks with a menu posted for an authorized representative to see. The teacher's desk and the last stall in the blue bathroom will serve as isolation areas for sick children. Cots were observed today. This facility plans to provide Individual Medical Services – IMS. A Plan of Operation that includes IMS must be submitted to the Department when any changes are made. 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.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

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: BUILDING KIDZ SCHOOL	FACILITY NUMBER: 435700740
	VISIT DATE: 06/16/2021

NARRATIVE

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The play yards are fenced in all around. The small climbing structures are cushioned to absorb a fall. Building overhang provides sufficient shade in the play yard. The center has pitchers and cups, as well as water bottles for indoor and outdoor activities. No cleaning agents were found stored with food. There is a microwave and refrigerators available. First aid supplies are available in the center. There is a working telephone on site. Carbon monoxide detector is is available and operable. Electronic sign in and out will be utilized with paper back up should the system crash.

Cindy Alvarez is a fully-qualified preschool director and has completed 16 hours of health and safety training including pediatric CPR and First Aid which is valid thru 9/12/2022.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and the director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

Zero Tolerance policies were explained. The center was found to be clean, safe, sanitary, and in good repair.

A license for 55 preschool children which includes up to 10 toddlers in the toddler option program will be issued on today's date, 6/16/2021.

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: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

LIC809 (FAS) - (06/04)

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