210107755-2-8-2023-05-CC-HLEG-CNV2HT-20230208162517

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 210107755
Report Date: 02/08/2023
Date Signed: 02/08/2023 04:25:23 PM

Document Has Been Signed on 02/08/2023 04:25 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	PARKSIDE PRESCHOOL		FACILITY NUMBER:	210107755
ADMINISTRATOR:	JONES, DAWN		FACILITY TYPE:	850
ADDRESS:	1000 SIR FRANCIS DRAKE BLVD		TELEPHONE:	(415) 991-9145
CITY:	SAN ANSELMO	STATE: CA	ZIP CODE:	94960
CAPACITY: 45	TOTAL ENROLLED CHILDREN: 33	CENSUS: 24	DATE:	02/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Dawn Jones		TIME COMPLETED:	04:40 PM

NARRATIVE

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On 2/8/2023, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the Parkside Preschool. The LPA was granted entry by the Director, Dawn Jones. The LPA explained the purpose of the visit to the director. All the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The LPA observed four staff members supervising twenty-four preschool children. Children's capacity and ratio requirements were observed to be in compliance,

LPA and the director both performed comprehensive inspections of the facility to look for possible threats to health and safety. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPA observed that the playground equipment and outdoor furnishings are in very good shape. The LPA noted that there were no bodies of water present at the facility. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order.

The director has stated that the facility does not house any firearms or other types of weapons.

The LPA observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities).

The LPA reviewed the records of five children. All required forms were in the files of the five children.

The LPA reviewed the records of four staff members. All required forms were in the files of the four staff members. A review of the training records of the four staff members reveals that three staff members are current with their CPR/First Aid certifications.

***See Page 2 for continuation***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PARKSIDE PRESCHOOL	FACILITY NUMBER: 210107755
	VISIT DATE: 02/08/2023

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Continued, Page 2
According to the director, the facility satisfies the requirements by carrying out simulations of fire and earthquake drills every other month, as well as by documenting their results.

The following reminders were discussed with the director:

1. All adults 18 and over living or working in a licensed childcare facility, 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 childcare facility.
2. Incidental Medical Services (IMS) policy
3. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. \

No deficiencies were issued today

A copy of this report, and the “Notice of Site Visit” were given to the director

A “Notice of Site Visit” must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Director, Dawn Jones

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

LIC809 (FAS) - (06/04)

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