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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001399
Report Date: 08/16/2024
Date Signed: 08/16/2024 11:30:08 AM

Document Has Been Signed on 08/16/2024 11:30 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:RCSD-ADELANTE-SELBY SPANISH IMMERSION CDCFACILITY NUMBER:
414001399
ADMINISTRATOR/
DIRECTOR:		ORTIZ, AIDAFACILITY TYPE:
850
ADDRESS:170 SELBY LANETELEPHONE:
(650) 482-5957
CITY:ATHERTONSTATE: CAZIP CODE:
94027
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 0DATE:
08/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Site Supervisor, Mandana Massoudi and Lead Teacher, Eneida ManriquezTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On August 16th, 2024 at approximately 8:30am, Licensing Program Analyst (LPA) Tapia-Mandujano arrived at facility for a Case Management-Licensee initiated. LPA met with Site Supervisor, Mandana Massoudi and Lead Teacher, Eneida Manriquez. Purpose of the inspection was explained. The purpose of the inspection was to approve the new playground. Present in the facility are Site Supervisor, Mandana Massoudi and Lead Teacher, Eneida Manriquez and other staff during a Professional Development Day. Due to the Professional Development Day, there are currently no children present. All adults are fingerprinted through the School District.

LPA measured the outdoor play areas. Facility has remodeled the outdoor playground area. Outside areas for facility consist of the gated playground in between CDC #1 and CDC #2, and the gated cement area in front of the facility. Total useable square footage measures 3,020.39; divided by 75 allows for a total of 40 children. Facility will need to request a Rotational Outdoor Waiver.

LPA inspected the outdoor play areas. Play area is not fully set up. Overall, outdoor play area is safe, is fully gated, and has a shading area in the playground area. Cemented area is also gated and is used mostly for ride on toys, and "running around" play. LPA has requested photos of the playground areas fully set up for approval.

During inspection, LPA reviewed and received copies of the Site Supervisor documentation packet for Mandana Massoudi.

Based on today's inspection, deficiencies were not observed, according to California Title 22, Health and Safety Code of Regulations.

Prior for approval of the new playground, facility must submit the following:
*Rotational Outdoor Waiver request
*Pictures of the outdoor areas fully set up ensuring areas are free of any potential hazards

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

Exit interview conducted and report was reviewed with Site Supervisor, Mandana Massoudi.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2024
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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