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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 210111549
Report Date: 01/06/2023
Date Signed: 01/06/2023 03:51:04 PM

Document Has Been Signed on 01/06/2023 03:51 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SANTA MARGARITA CHILD CARE CENTERFACILITY NUMBER:
210111549
ADMINISTRATOR:URYU, ARLEENFACILITY TYPE:
850
ADDRESS:1055 LAS OVEJASTELEPHONE:
(415) 499-1277
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 45TOTAL ENROLLED CHILDREN: 42CENSUS: 31DATE:
01/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Claudia CadenaTIME COMPLETED:
04:05 PM
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On 1/6/2023, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the Santa Margarita Child Care Center. The LPA was granted entry by the Assistant Director, Claudia Cadena. The LPA explained the purpose of the visit to the assistant director. Guardian, the department's system for conducting background checks, has confirmed that 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 six staff members supervising thirty-one children. Children's capacity and ratio requirements were observed to be in compliance,

LPA and the assistant 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 assistant 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 five staff members. All required forms were in the files of the five staff members. A review of the training records of the five staff members reveals that all five 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: 01/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2023
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SANTA MARGARITA CHILD CARE CENTER
FACILITY NUMBER: 210111549
VISIT DATE: 01/06/2023
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According to the assistant director, the facility satisfies the requirements by carrying out simulations of fire and earthquake drills monthly, 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 the home, 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 Family Child Care Home.
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 assistant 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 Assistant Director, Claudia Cadena

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023
LIC809 (FAS) - (06/04)
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