414004671-11-17-2023-05-CC-LTMO-CXNT4Y-20231117132444

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004671
Report Date: 11/17/2023
Date Signed: 11/17/2023 01:26:20 PM

Document Has Been Signed on 11/17/2023 01:26 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:	ALPHA KIDS ACADEMY LLC		FACILITY NUMBER:	414004671
ADMINISTRATOR:	JUNE KEO		FACILITY TYPE:	850
ADDRESS:	201 RAVENSWOOD AVENUE		TELEPHONE:	(415) 664-8080
CITY:	MENLO PARK	STATE: CA	ZIP CODE:	94025
CAPACITY: 38	TOTAL ENROLLED CHILDREN: 34	CENSUS: 24	DATE:	11/17/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Licensee, Natella Shtern		TIME COMPLETED:	01:40 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On November 17th, 2023 at approximately 9AM, Licensing Program Analysts (LPA) Leslit Tapia-Mandujano and Janet Gil conducted an unannounced, annual inspection. LPA met with Licensee, Natella Shtern and explained the purpose of the inspection. Present in the facility are Licensee and six staff caring for a total of 24 children (Six toddlers and 18 preschool age children). All adults working in the facility are fingerprint cleared and associated to the facility. Facility is currently operating within teacher to child ratio on this date. Facility is a combination license with an infant license. Facility operates in the main classroom for Toddler component. Preschoolers uses the four classrooms. The hours of operation are Monday-Friday from 7:30am to 5:30pm. LPAs conducted a health and safety hazard inspection. LPA observed classroom to be clean and equipped with age appropriate toys and materials. Storage for children's belongings are located in the entryway of facility, labeled with each child's individual names. LPA observed facility has an installation of a fire alarm system inside each classroom as well as a fully charged, fire extinguishers. The classrooms have a smoke and carbon monoxide detector installed as well as emergency kits with first aid materials and emergency contact information. There are currently no children with medication. Facility has a plan to properly store Medication, inaccessible to enrolled children and maintained with proper documentation in the Kitchen area. All poisons, cleaning solutions and hazardous materials are stored inaccessible to children in off limit areas or facility high shelves. Facility offers snacks and parents bring in lunch. Water is available to children indoors and outdoors. Facility has requested a waiver for lead testing and water usage. Waiver is pending. Toddlers have their own physical space inside and outside. Toddler use mats for sleeping, no cribs or play yards are in use. Continued on Page 2..

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2023

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)

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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: ALPHA KIDS ACADEMY LLC	FACILITY NUMBER: 414004671
	VISIT DATE: 11/17/2023

NARRATIVE

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Outdoor area appears to be clean and orderly. There are a variety of outdoor equipment that are in good working condition. Children are signed in and out of facility with parents' signatures. Facility has license documentation and information properly posted and available for review in the entrance. There are no pools or bodies of water on the promises.

LPAs reviewed facility records that included 6 children's records and 5 staff records. LPAs observed children's records to be complete. At least one staff have an up to date CPR & First Aid certificate. Staff have up to date Mandated Reporter Certificate. Last emergency drill was conducted 10/2023. Emergency drills are conducted at least once every six months and are properly logged and documented.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023

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: ALPHA KIDS ACADEMY LLC	FACILITY NUMBER: 414004671
	VISIT DATE: 11/17/2023

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on today's inspection, deficiencies were observed, according to California Title 22, Health and Safety Code of Regulations.

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

Exit interview conducted and report was reviewed with Licensee, Natella Shtern.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/17/2023 01:26 PM - It Cannot Be Edited

Created By: Leslit Tapia-Mandujano On 11/17/2023 at 12:47 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ALPHA KIDS ACADEMY LLC	FACILITY NUMBER: 414004671
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as there is no water testing has been done in the facility by January 2023 and there is no waiver approved to waive getting tested which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/18/2023
	Plan of Correction
1 2 3 4	Based on Interview with licensee, she has submitted for a waiver request on Spetember 14th, 2023 as the facility uses water delivery for drinking and if they need to prep food. Facility must obtain an approved waiver.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Marie Rodriguez

LICENSING EVALUATOR NAME:

Leslit Tapia-Mandujano

LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023

LIC809 (FAS) - (06/04)

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