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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410500701
Report Date: 09/28/2023
Date Signed: 09/28/2023 11:46:44 AM

Document Has Been Signed on 09/28/2023 11:46 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:WOODSIDE PARENTS' NURSERY SCHOOLFACILITY NUMBER:
410500701
ADMINISTRATOR:TRUDELL, KARENFACILITY TYPE:
850
ADDRESS:3154 WOODSIDE ROADTELEPHONE:
(650) 851-7112
CITY:WOODSIDESTATE: CAZIP CODE:
94062
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: DATE:
09/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:27 AM
MET WITH:Diana ArevalosTIME COMPLETED:
12:00 PM
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On September 28, 2023, at 8:30 AM Licensing Program Analyst (LPA) Maria Olguin-Leon and (LPM) Marie Rodriguez met with Director Diana Arevalos for a required annual inspection. Purpose of inspection was explained. Present today, Director, 4 teachers, and 19 preschoolers. Facility is operating within capacity and in compliance with staff child ratio. All staff have fingerprint clearances. Facility operates preschool program from Monday to Thursday 8:30 AM to 12:15 PM & Friday 9:00 AM to 12:00 PM.

LPA, LPM and Director toured the facility for health and safety hazards. Facility operates a parent co-op preschool program on the site of Woodside Village Church. Preschool programs are in classroom #5, #6, #7 and #8. LPA inspected all 4 preschool classrooms. Facility is clean with proper temperature and ventilation. There are plenty of age-appropriate toys, furniture, and learning materials all in good repair. Storage cubbies are available for children to store personal items and belongings. Facility has two children restrooms equipped with working toilets and sinks. One restroom has a foldable changing table available. There is a separate bathroom in facility for staff use. Trash containers in bathroom and in classroom have tight fitted lids. All cleaning products, chemicals and toxins are stored and locked in a cabinet and inaccessible to children.

Playground is equipped with a large play structure in good condition. There are plenty of water activities toys, playhouse, and riding toys all in good condition. Playground flooring is cushioned with tanbark to cushion falls. Playground is surrounded with a 5 ft. fence. Per Director, there are no weapons or firearms on the premises.

Facility provides limited snacks to children. Refrigerator was observed to be clean and food stored properly to prevent contamination. Labeled water bottles with children’s names are brought from home for use indoors and outdoors. Facility refills water with water filtered pitchers. First aid kit is fully stocked with medical supplies. Incidental Medical Services were discussed. Sick children are isolated in office away from other children.

Cont. Page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2023
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: WOODSIDE PARENTS' NURSERY SCHOOL
FACILITY NUMBER: 410500701
VISIT DATE: 09/28/2023
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LPA reviewed sign in/out sheet, which is available in front of classroom. LPA reminded Director to have parents sign with complete signature. Facility roster is up to date. Facility is equipped with fully charged fire extinguishers, working dual carbon monoxide/smoke detector. Facility is equipped with a landline phone and staff use cell phones for communication.

LPA reviewed 5 children’s records and 4 staff records. All the children's and staff records were complete. The facility has all necessary paperwork posted, Facility License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan. Last emergency drill was conducted on June 29, 2023.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Cont. page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: WOODSIDE PARENTS' NURSERY SCHOOL
FACILITY NUMBER: 410500701
VISIT DATE: 09/28/2023
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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA checked lead website to verify lead testing.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

No deficiencies were issued today.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Diana Arevalos.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
LIC809 (FAS) - (06/04)
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