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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001934
Report Date: 11/16/2023
Date Signed: 11/16/2023 01:42:20 PM

Document Has Been Signed on 11/16/2023 01:42 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:SAN MATEO-FOSTER CITY SCHL DIST - PARK SCHOOLFACILITY NUMBER:
414001934
ADMINISTRATOR:CRISTINA HALEYFACILITY TYPE:
850
ADDRESS:161 CLARK DRIVE, LG-1TELEPHONE:
(650) 312-7577
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 10DATE:
11/16/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Amanda DriscollTIME COMPLETED:
01:00 PM
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On 11/16/2023 at 8:45AM., Licensing Program Analyst (LPA) Luis J. Gomez met with Principal, Karrie Hasselton. During inspection, Principal Amanda Driscoll arrived to accompany the LPA. Purpose of inspection was explained and was for Unannounced, Case Management Inspection for increase in Capacity/ Room Addition. Facility has requested to increase their capacity to 48 children. The shared, outdoor play space will remain the same. Waivers to share outdoor play yard with school-age children has been posted in facility. Updated schedule was submitted during inspection. Present during inspection was the principal and 3 staff caring for 10 children. Per principal, preschool program operates year around, from 8:30AM- 4:30PM. Per principal, during summer session, one classroom will be closed. LPA measured and inspected facility, indoors and outdoor, for health and safety hazards.

At 9:00AM., LPA measured classrooms #2. The total useable square footage for classroom #2 is 819.43 sq. ft. Total usable square footage divided by 35, equals to 23 children. After adding of the allowed capacity to current licensed capacity of 24, facility is provided with a total capacity of 47 children. LPA observed children’s bathroom was equipped with 3 toilets, 2 sinks. Fixtures tested were in operating conditions. Sinks deliver water that is no warmer than 120 degrees. There is a separate bathroom for staff usage on the premises. Classroom #2, total allowable capacity for toilets (3) is 45 children and sinks is 30 children.



Classroom#2 was observed clean, orderly, with age-appropriate playthings. Furniture and materials inspected were in safe condition. LPA observed storage cubbies available for children's belongings. Classroom has a fully charged fire extinguishers (3A:40BC), and built-in, smoke/ carbon monoxide combination detector. Accessible trash bins and outlets have had coverings installed. First aid kit is readily available. The facility has proper ventilation and lighting. (REFER TO 809C FOR CONT.)
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 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: SAN MATEO-FOSTER CITY SCHL DIST - PARK SCHOOL
FACILITY NUMBER: 414001934
VISIT DATE: 11/16/2023
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(Page 2)
At 10:20AM., LPA measured the shared, outdoor play yard. Outdoor: Total useable square footage of outdoor play yard measures 5,469 sq ft. Total usable area divided by 75 sq ft allows for a total of 72 children. LPA observed outdoor play space was enclosed. Resilient material has been installed around and underneath play structure. Play structure was properly anchored. Per principal, water services will be readily available with accessible fountains and refillable bottles.

Per principal, lunches and snacks will be provided by program. LPA reminded principal to ensure food brought to the facility is properly labelled. Medications will be stored in each classrooms. All toxins and other hazardous items will be stored in each classroom inaccessible to children. Isolation of ill children will be in the main office.

Facility provides Incidental Medical Services – IMS. LPA reviewed storage area for medication and equipment/supplies, and reviewed forms that will be used. For IMS information see Title 22 Regulations sections 101173 and 101226. 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: http://www.ada.gov/childqanda.htm

During inspection, principal submitted an updated Parent Handbook.

(REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
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: SAN MATEO-FOSTER CITY SCHL DIST - PARK SCHOOL
FACILITY NUMBER: 414001934
VISIT DATE: 11/16/2023
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Prior to recommendation for approval of new the preschool classroom (#2) and Increase of Capacity, facility must complete the following:
*Obtain fire clearance (STD850).
*Finish construction of preschool bathroom
*Make off-limit areas inaccessible.
*Post required posting in visible location: (PUB269), (PUB394), (LIC610), and (LIC613A).
*Obtain napping equipment for requested capacity.
*Test drinking water outlets for lead contamination levels.

>No deficiencies were observed according to CCR, Title 22. Sec.12 Ch. 1.

This report must be available in the facility for public review. Notice of site visit was observed being posted. Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3