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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004172
Report Date: 08/31/2022
Date Signed: 08/31/2022 03:07:19 PM

Document Has Been Signed on 08/31/2022 03:07 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:PFS - EARLY LEARNING CDC - INFANT CENTERFACILITY NUMBER:
414004172
ADMINISTRATOR:VILLALPANDO,ADRIANAFACILITY TYPE:
830
ADDRESS:24 SECOND AVENUETELEPHONE:
(650) 403-4300
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 6DATE:
08/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Adriana VillalpandoTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Marie Rodriguez conducted an unannounced annual inspection. LPA met with Site Supervisor Adriana Villalpando and explained purpose of inspection. The facility is a combination center with an infant and a preschool/toddler programs. Preschool/toddler program operates under separate license #414004932. Present in the infant center were the Site Supervisor, two teachers, and six infants. Center is operating within capacity requirements and in compliance with child to staff ratio. Hours of operation are Monday to Friday from 7:00am to 5:30pm.

LPA inspected infant room, gross motor skills room, and outdoor play area with Site Supervisor. There are no bodies of water, firearms, or weapons on the premises. The center is in good repair with proper temperature and ventilation and is free of any hazards. All furniture is in good condition. Room has age appropriate toys and equipment. Room has a separate napping room. Cribs are in good condition. Older infants use a cot which is properly stored when not in use. A first aid kit is available in each classroom. All cleaning products and toxins are inaccessible to children. Outdoor play area is fenced for supervision. Outdoor toys and equipment in play area are age appropriate and in good condition and play structures have appropriate cushioning underneath. Outdoor play area is shared with the toddler program. Motor gross skills room has age appropriate toys and equipment. There is a rotation schedule for all programs to use room.

All required postings and waivers are properly posted on the bulletin board in the infant room. Morning and afternoon snacks and lunch are provided by the center. Meals are provided through an outside vendor. Kitchen area is clean and free of any toxins or contamination. All food is properly stored to avoid contamination. All storage containers for solid waste have a proper lid. Changing table is in good repair and is disinfected after each use. A sink is next to changing table. There is a bathroom for staff usage on the premises.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2022
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: PFS - EARLY LEARNING CDC - INFANT CENTER
FACILITY NUMBER: 414004172
VISIT DATE: 08/31/2022
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Last emergency drill was conducted in July 2022. Emergency drills are conducted at least once every six months and are properly logged. Paper sign-in/out sheets are located inside a binder in the classroom. The center has a complete paper record of sign-in/out sheets by authorized pickup person. There is a working fire alarm and sprinkler system throughout the center. A carbon monoxide detector and a fully charged fire extinguisher is in the classroom and a working telephone is available on-site.

Six children records reviewed were complete. All children have a record of emergency identification information on file. Three staff records reviewed were complete. All staff have a criminal record clearance on file. Site Supervisor and staff have current pediatric first aid/CPR certificates on file.

No deficiencies cited today under California Code of Regulations, Title 22, Division 12.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 (US DOJ) 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.

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.

Facility Representative 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.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: PFS - EARLY LEARNING CDC - INFANT CENTER
FACILITY NUMBER: 414004172
VISIT DATE: 08/31/2022
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LPA discussed the safe sleep regulations with Facility Representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Facility Representative 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.

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 was conducted and report was reviewed with Facility Representative Adriana Villalpando.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022
LIC809 (FAS) - (06/04)
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