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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700743
Report Date: 05/11/2022
Date Signed: 05/11/2022 12:24:40 PM


Document Has Been Signed on 05/11/2022 12:24 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:HEFFALUMP SCHOOLFACILITY NUMBER:
435700743
ADMINISTRATOR:THAKUR, MEENAKSHIFACILITY TYPE:
850
ADDRESS:3990 VENTURA COURTTELEPHONE:
(415) 425-4340
CITY:PALO ALTOSTATE: CAZIP CODE:
94306
CAPACITY:20CENSUS: 7DATE:
05/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Meenakshi ThakurTIME COMPLETED:
12:37 PM
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On 5/11/2022, 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 Director, Meenakshi Thakur. Present for this inspection were the Director, one fingerprint cleared and associated staff member, and seven preschool aged children in care. Facility operating hours are 8:30AM-1:30PM M-F with extended care offered until 5pm M-F. The facility was toured to conduct a health and safety inspection.

At 8:41am, LPA toured the facility classroom. The facility consists of one classroom and one outdoor play area located along Ventura Court. The classroom is 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 classroom. 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. LPA observed adequate amounts of paper towels and hand soap available to children in the bathroom during today's inspection.

The outdoor activity space was toured at 09:21am. The outdoor activity space is fenced and was observed to be in safe condition during this inspection. All play equipment is operable and age-appropriate. Areas around high climbing equipment have cushioning material to absorb falls. Uncontaminated drinking water is available to children in the outdoor play area.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan WilliamsTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2022
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: HEFFALUMP SCHOOL
FACILITY NUMBER: 435700743
VISIT DATE: 05/11/2022
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At 9:46am, LPA toured the food preparation area. Food is prepared by parents and is sent to the center with their children. At this time, the facility only provides reserve snack food to children who are sent to the center without food. Food is properly stored and Director stated that contaminated food is discarded immediately. Refrigerator was observed to be maintained in working order and was found to be free of evidence of rodents and other vermin at this time.

At 9:54am, LPA reviewed sign in/sign out sheet. LPA observed seven signatures out of seven children present in the facility during today's inspection.

The facility has one fully charged 3A40BC fire extinguisher and working telephone. Carbon monoxide/smoke detectors are serviced regularly by a fire inspector arranged for by Palo Alto Community Child Care. At least one staff member present today has current CPR/1st Aid certificate. The facility is in ratio today. Children's files and staff files were reviewed for proper documentation. All required forms are posted in public view. Facility roster was obtained.

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

Director 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.

Director 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 Director that all forms can be downloaded at www.ccld.ca.gov and encouraged the Director to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Director 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 NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan WilliamsTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
LIC809 (FAS) - (06/04)
Page: 9 of 9
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: HEFFALUMP SCHOOL
FACILITY NUMBER: 435700743
VISIT DATE: 05/11/2022
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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 Director. Appeal rights were provided to the Director and the signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan WilliamsTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
LIC809 (FAS) - (06/04)
Page: 2 of 9