410504640-10-10-2023-05-CC-CQUO-CWGQ3B-20231010114830

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410504640
Report Date: 10/10/2023
Date Signed: 10/10/2023 11:48:37 AM

Document Has Been Signed on 10/10/2023 11:48 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:	PARKER, ANGELA		FACILITY NUMBER:	410504640
ADMINISTRATOR:	PARKER, ANGELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 369-0675
CITY:	MENLO PARK	STATE: CA	ZIP CODE:	94025
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 12	CENSUS: 8	DATE:	10/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Angela Parker & Cathleen Parker		TIME COMPLETED:	12:00 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	On October 10, 2023 at approximately 8:50am, Licensing Program Analyst (LPA) Catrina Quimbo, conducted an unannounced, annual inspection. LPA met with licensee, Angela Parker, and licensee's daughter, Cathleen Parker, and explained the purpose of the inspection. Present in the home is licensee, licensee's daughter, licensee's assistant (A1) and 8 children (2 infants and 6 preschool age). Licensee is operating within capacity limits and ratio during LPA's visit. Licensee lives in the single level home with their spouse and A1. All adults living and/or working in the home have fingerprint clearance on file. Hours of operation are Monday through Friday 8:00am to 5:30pm. The DAY CARE AREAS are the living room (main playroom), family room (playroom #2), hallway bathroom, bedroom #1 (napping room), kitchen, laundry room (pass by to backyard), backyard and front yard. The OFF LIMIT AREAS are bedroom #2, bedroom #3, and garage. Off limit areas are appropriately barricaded. There are stairs in the backyard that were observed to have a child safety gate. LPA toured day care areas of home with licensee and licensee's daughter. LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of toys and materials that were observed to be in good condition. LPA observed sharp edges to have appropriate padding for additional safety. There is a fireplace in the living room that is appropriately barricaded and made inaccessible. LPA did not observe electrical outlets to be accessible. Cleaning supplies, poisons and hazardous materials are made inaccessible behind child safety locked cabinets and/or stored in home's high shelves. Home is equipped with a fully charged fire extinguisher, smoke alarm and carbon monoxide detector. LPA tested carbon monoxide detector in hallway and observed detector to be in working condition. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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: PARKER, ANGELA	FACILITY NUMBER: 410504640
	VISIT DATE: 10/10/2023

NARRATIVE

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Napping room was observed to be equipped with cribs that does not hinder the entrance/exit. LPA observed cribs to be free of loose articles, bumper pads, and pillows. LPA observed cribs to have mattresses with tight fitting sheets. Licensee maintains sleeping logs for napping infants. LPA observed sleeping logs to document the 15 minute time check of when infant was last checked on and the initials of the staff member who checks on the napping infant.

Bathroom for children's use was observed to be in proper working condition. Cabinets in bathroom were observed to have child safety locks installed. LPA did not observe any hazardous materials to be accessible in bathroom.

Backyard and front yard are entirely enclosed and fenced. Outdoor areas are equipped with a variety of toys and materials that were in good condition. There is sufficient shade for children when needed. LPA did not observe any pools, spas or bodies of water on site.
LPA reviewed six children’s records, which were complete. Children’s files have a record of emergency identification information and record of past sleeping logs. Licensee, licensee's daughter and A1 all have a current and valid CPR/First Aid certification and Mandated Reporter certification. Licensee's Pediatric First Aid/CPR is current and will expire 05/2025. Emergency drills are properly documented and maintained. Last emergency drill was conducted 05/09/2023. Licensee has licensing documentation properly posted and available for review. Licensee maintains a childcare roster that was made available for review. Per licensee, there are no weapons or firearms in the home.

LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com. Licensee was reminded Mandated Reporter training must be renewed every 2 years and all staff whom directly work with children must complete training.

Licensee was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.
(Continue Report on Page 3...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: PARKER, ANGELA	FACILITY NUMBER: 410504640
	VISIT DATE: 10/10/2023

NARRATIVE

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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.

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed the safe sleep regulations with licensee and
discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee 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.

During the exit interview, the licensee, Angela Parker, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted and report was reviewed with the licensee, Angela Parker

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC809 (FAS) - (06/04)

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