410519000-10-14-2022-05-CC-LGOZ-CK7R4Q-20221014124156

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410519000
Report Date: 10/14/2022
Date Signed: 10/14/2022 12:43:16 PM

Document Has Been Signed on 10/14/2022 12:43 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:	SERENDIPITY SCHOOL		FACILITY NUMBER:	410519000
ADMINISTRATOR:	CEREFICE, LAURIE		FACILITY TYPE:	850
ADDRESS:	3172 CLEARVIEW WAY		TELEPHONE:	(650) 574-7400
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY: 116	TOTAL ENROLLED CHILDREN: 116	CENSUS: 85	DATE:	10/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Laurie Cerefice		TIME COMPLETED:	12:50 PM

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On 10/14/2022 at 8:35AM., Licensing Program Analyst (LPA), Luis J. Gomez met with Director, Laurie Cerefice. Purpose of the inspection was explained and was for an unannounced; annual random inspection. Present was the director and 12 staff, supervising 85 children. Children present had been properly signed in. Staff have criminal record clearances on file. Preschool program utilizes seven classrooms, Lower Building: Pandas (3 year old); Flamingos, (3 year old); Monkeys (2 year old); Lamas (3 year old), Upper Building: Shining Stars (4 year old); Lady Bugs (4 year old); and Brown Bears (4 year old). Facility utilizes four outdoor areas: Main Play Yard, Front Play Yard, Patio and Side Yard. Days and hours of operation are Monday- Friday 8:00AM- 5:00PM. Program operates year-around. LPA inspected facility, indoors and outdoors, with director for health and safety hazards.

At 8:55AM., the following was observed: classrooms inspected were clean, orderly, and equipped with age-appropriate playthings for the children. All floor and ground surfaces were free of obstructions. Furniture and items inspected were in proper repair. Classrooms had individual cubbies/ storage containers and child size tables and several chairs for activities. For napping services, LPA observed stackable cots in each classroom (properly labeled). Per director, napping supplies are washed weekly by families.

Children’s bathrooms were reviewed during inspection. Fixtures tested were in operating condition and bathrooms had adequate supplies for hand washing. Diaper changing table is in the lower building. Per director, table is disinfected by staff after each use. Staff bathroom is located separately.

At 9:05AM., Based on observations, LPA confirmed accessible cleaning wipes in facility’s Lama classroom. Wipes were made inaccessible during inspection. Advisory Note: Technical Assistance (LIC9102TA) was issued. Accessible outlets had been covered.

Classrooms were proper temperature, with ventilation and lighting. Facility had functioning telephone service; smoke/ carbon monoxide combination detector (built-in); and fire extinguishers, 3A:60BC. First aid kit was review during inspection. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SERENDIPITY SCHOOL	FACILITY NUMBER: 410519000
	VISIT DATE: 10/14/2022

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(Page 2)
At 9:45AM., LPA inspected outdoor play areas. Outdoor areas were completely enclosed, with accessible shaded rest areas. Play structures were observed properly anchored, and playthings were in like-new condition. For added safety, play sand and wood chips had been installed around play structures. Sandboxes were free of hazards and foreign materials.

LPA reminded director to ensure drinking water is available in the outdoor play area.

At 10:20AM., LPA review the facility records including seven children's files and seven personnel files. Facility files reviewed included, Criminal Record Statement (LIC508); Declaration to Report Suspected Child Abuse (LIC9108); Teacher’s Transcripts; Proof of Immunization; Notice of Employee Rights (LIC9052); and required ‘Mandated Reporter Training’ Certification (AB1207).

Children's files were reviewed and included: Health History (LIC702); Identification of Emergency Information (LIC700); Consent for Medical Treatment (LIC627); Notification of Parent’s Rights (LIC995); and Immunization Records.

Staff present had the ‘Cardiopulmonary Resuscitation/ First Aid’ certification, which expires 05/2023. Facility is conducting Fire/ Earthquake drills every six months, with last drill done on 6/16/2022 properly logged.

Required forms were posted in lobby and included the: Childcare License; Updated Snack Menu (October); Notification of Parents Rights (PUB393); California Child Passenger Safety Law Posting; and Updated Emergency Disaster Plan (LIC610A).

Per director, facility provides provide food services. Facility kitchen was reviewed during inspection. Kitchen was free of litter/ rubbish and all food items inspected were current.

Children's medication was reviewed during inspection.
(REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022

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: SERENDIPITY SCHOOL	FACILITY NUMBER: 410519000
	VISIT DATE: 10/14/2022

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(Page 3)
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 Child Care Center. A civil penalty of $100.00 minimum/ day up to $500.00 maximum per day/per person will be assessment if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on today's inspection, no deficiencies were observed in the areas evaluated, according the Title 22 Division 12 Ca. Code of Regulations. Exit interview and report was discussed with Director, Laurie Cerefice and signatures on this form acknowledges receipt of these documents.

The 'Notice of Site Visit' was provided to director and must remain posted for 30 days.

This report and rights to comment were discussed. Report must be available in the facility for public review. For additional questions, facility was advised to contact the Community Care Licensing Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022

LIC809 (FAS) - (06/04)

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