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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000808
Report Date: 05/08/2025
Date Signed: 05/08/2025 05:58:21 PM

Document Has Been Signed on 05/08/2025 05:58 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:IHSD, INC-MENLO PARK HEAD START CENTERFACILITY NUMBER:
414000808
ADMINISTRATOR/
DIRECTOR:		EDITH HERNANDEZFACILITY TYPE:
850
ADDRESS:419 6TH AVENUETELEPHONE:
(650) 779-0416
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 16DATE:
05/08/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:27 AM
MET WITH:Edith HernandezTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On May 8, 2025 at approximately 8:30AM, Licensing Program Analyst (LPA) Krenn conducted an unannounced, annual, inspection. LPA met with Site Supervisor, Edith Hernandez. Present in the facility are Site Supervisor and three staff supervising a total of 16 preschool age children. The facility remains within its capacity limits and meets the required ratios for today’s visit. All staff present have fingerprint clearance and are associated to the facility.

Facility operates in one classroom, with an outdoor play area available in the back of the facility.
Program operates Monday - Friday from 8am-4pm, following a 10-month program (August through May) with periodic breaks throughout the year. This school enrolls children ages 3 – 5 years old.
All the children enrolled at this preschool attend fulltime, and the facility does not take drop-ins.

LPA observed that all required documents: such as the facility license, notification of parents’ rights, personal rights, car seat laws, and emergency disaster plan, were displayed and visible to the public. LPA observed that children are signed in and out of facility with parents' signatures electronically.

LPA observed classroom to be clean and equipped with age-appropriate toys, furniture, and educational materials. Storage for children's belongings are located inside the classroom, which included hooks, bins with lids, and shelves. The storage space is labeled with each child's individual name and photo. Electrical outlets were fitted with sliding child safety covers to prevent children's access. There is a bathroom available for the children. LPA observed it to be clean, fully operational, and equipped with suitable toileting equipment and sanitation products. Staff use a separate bathroom that is kept inaccessible to the children.



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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: IHSD, INC-MENLO PARK HEAD START CENTER
FACILITY NUMBER: 414000808
VISIT DATE: 05/08/2025
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LPA observed facility has a fire alarm system inside the classroom as well as a fully charged, fire extinguisher. The classroom has two combination smoke and carbon monoxide detectors in the classroom. LPA tested them and found them to be functioning. LPA inspected the emergency backpack kit with first aid materials and emergency contact information. Last emergency drill was conducted 04/2025. Emergency drills are conducted monthly at this facility and are properly logged and documented.

LPA observed that medication is stored appropriately, inaccessible to enrolled children, clearly labeled, and with proper documentation. One of the children currently enrolled has an allergy, the facility has an epi-pen stored in the area where children eat. The facility has informed the caterer and the other parents of the allergy. During a morning outdoor inspection, staff noticed peanut shells. Upon investigation the staff found that the neighbor was feeding peanuts to squirrels. The neighbor agreed to stop feeding peanuts to the squirrels. The facility has inhalers stored in the classroom near the door to the outdoor area, so they can be accessible if needed inside or outside.

LPA observed a cabinet in the kitchen containing soap to be in an area accessible to the children. LPA advised Site Supervisor to put child locks on that cabinet. Site Supervisor agreed and said they would be installed tomorrow.

The facility offers stackable cots for children to rest or nap. There is space between the cots when stacked allowing for air flow. Each cot is clearly labeled with each child’s name. LPA observed that clean sheets and bedding was available for the children. Per the Site Supervisor blankets are from home and are washed at home every weekend. The facility provides sheets which are laundered on site weekly.

The outdoor playground has a fence that is at least four feet tall. The play equipment is in good condition and does not have sharp, loose, or pointed parts. The areas around and under climbing equipment and slides are cushioned with rubber playground flooring to cushion falls. There are no pools, spas, or bodies of water on the property.


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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2025
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: IHSD, INC-MENLO PARK HEAD START CENTER
FACILITY NUMBER: 414000808
VISIT DATE: 05/08/2025
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Facility offers breakfast, lunch, and snacks through Chefables. Monthly menu is posted in the classroom. LPA observed that menus include healthy options such as fresh fruits, vegetables, and whole grains daily. Filtered water is available to children indoors and outdoors.

LPA reviewed the files of five children, which are kept electronically, confirming that their emergency contact and medical information were complete and in order.

LPA reviewed four staff files and confirmed that all necessary forms were complete and in order. LPA verified that all teachers held current Pediatric First Aid and CPR certifications. During a review of the staff transcripts, LPA found that two teachers and one associate teacher are fully qualified according to the requirements of their positions. LPA saw complete vaccination records. One of the teachers did not have current Mandated Reporter Training on file, but LPA verified that a digital copy was completed and current. Site Supervisor printed the certificate and added it to the file during the visit.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.



Site Supervisor 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 a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

No deficiencies were cited during today's inspection.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Site Supervisor, Edith Hernandez.
NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2025
LIC809 (FAS) - (06/04)
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