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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004701
Report Date: 09/30/2022
Date Signed: 09/30/2022 10:11:45 AM

Document Has Been Signed on 09/30/2022 10:11 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:AFTERSCHOOL CARE ENRICHMENT-AT MARIPOSAFACILITY NUMBER:
414004701
ADMINISTRATOR:AGUILA, ANTHONYFACILITY TYPE:
840
ADDRESS:750 DARTMOUTH AVENUETELEPHONE:
(650) 226-3480
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY: 60TOTAL ENROLLED CHILDREN: 85CENSUS: 0DATE:
09/30/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Eve DaskalakisTIME COMPLETED:
10:15 AM
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On September 30, 2022 at 8:40 AM, Licensing Program Analyst (LPA) April Cowan conducted an announced case management inspection for a capacity change today and room addition. LPA met with the licensee, Eve Daskalakis. The purpose of the inspection is explained. Present in the facility is licensee and 3 staff. There are no present during this inspection. The case management is related to an application that was submitted by the licensee to regional office. Licensee requests to increase the capacity from 60 to 95 with the addition of Room O.

LPA inspects the room for health and safety hazard. LPA observed that there is a working smoke detector, carbon monoxide detector, and fire extinguishers available in the classroom. All of the cleaning solutions, poisons, and other chemicals that are dangerous to the children are stored inaccessible to the children. Room has age appropriate furniture. Furniture is steady and in good repair. Room floor is in good repair and free of any hazards. All toilets, hand washing facilities are in working condition with proper sanitation in place. Staff bathrooms were available. Licensee has a letter from San Carlos School District stating that the school district is allowing 35 students in Room O. Regional office has received approved fire.

LPA is approving the addition of Room O to license. License now consist of Rooms S, T, and O. LPA is approving the increase of capacity from 60 to 95.


This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For a quarterly update on Licensing information, go to the CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2022
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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