414004790-8-23-2021-05-CC-MROZ-C66SXE-20210823141548

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004790
Report Date: 08/23/2021
Date Signed: 08/23/2021 02:15:58 PM

Document Has Been Signed on 08/23/2021 02:15 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:	ALL FIVE		FACILITY NUMBER:	414004790
ADMINISTRATOR:	THOMSEN, CAROL		FACILITY TYPE:	830
ADDRESS:	415 IVY DRIVE		TELEPHONE:	(650) 394-7328
CITY:	MENLO PARK	STATE: CA	ZIP CODE:	94025
CAPACITY: 18	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	08/23/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Carol Thomesn		TIME COMPLETED:	02:30 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	Licensing Program Analyst (LPA) Marie Rodriguez conducted a scheduled Pre-Licensing inspection and met with Applicant Carol Thomsen. This inspection included a technical assistance inspection for COVID-19 guidance and support. The applicant is requesting a total capacity of 18 children (age range from birth to two years old). Applicant is also requesting a toddler option component as well for 12 children in the total capacity of 18 children. The facility will operate from Monday - Friday; 7:30 AM to 5:30 PM. The designated director/site supervisor for the facility is Carol Thomsen. Main entry to the building is at 1391 Chilco Street using the second gate next to current preschool license #414004132. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity. Indoor: Portable classroom 13 will be used for the infant program and portable classroom 14 will be used for the toddler component. Total useable indoor area measures at 1,407.70 sq ft divided by 35 sq ft equals 40 children. Applicant is requesting a total capacity of 18 children. The indoor space for children in both classrooms is observed today to be clean and all furnishings, toys, and equipment observed to be safe and in good condition. There is a storage space for children's personal belongings in both classrooms. Cots will be utilized for napping children in the toddler classroom. Facility will provide a sheet and blanket for each child and bedding will be sent home to be laundered weekly. Cots will be cleaned at every evening or more often if needed. Cribs are assigned for each infant. Children will be signed in and out electronically through the Brightwheel app. The indoor space is equipped with a fire extinguisher in each classroom, smoke and carbon monoxide detectors, a separate kitchen area where food will be stored, garbage cans with tight-fitting lids, a first aid kit, and emergency supplies. The facility is adequately ventilated and free of insects and bugs. Facility will provide breakfast, lunch, and snacks to children through outside food service vendor Chefables. (Continued on next page)

SUPERVISORS NAME: Alma Malig
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021

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: ALL FIVE	FACILITY NUMBER: 414004790
	VISIT DATE: 08/23/2021

NARRATIVE

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There are two toilets and two sinks accessible for children's use in the toddler classroom (one sink in the bathroom and one sink outside of the bathroom). Bathroom is located in-between the infant and toddler classrooms. There is a designated space for a diaper changing station in each classroom and will be cleaned after each use. The bathroom will be cleaned and disinfected in-between use by each child. The bathroom was observed to be clean and with no health and safety hazards. Sinks accessible to children will deliver cold and warm water. A separate bathroom is available for staff.

Food will be stored in the kitchen separately from any cleaning products or other hazards. All toxins and other hazardous items will be stored in a cabinet above the sink and will be inaccessible to children. Medications will be stored in a cabinet in a locked box in each classroom inaccessible to the children. During the COVID-19 pandemic, staff will provide children with disposable cups of water by utilizing a water cooler. Long term plan is to use resusable cups which will be washed at facility on a daily basis. Isolation of ill children will be in the Director's office and staff bathroom will be used for an ill child.

Outdoor: The outdoor areas measure a total of 4170.99 sq ft. allowing for a total of 56 children. Outdoor area is observed to be clean, safe and equipped with toys and equipment for children. Shade is provided through trees on premises and by portable shade structures. During the COVID-19 pandemic, disposable cups of water will be dispensed by staff. Long term plan, for outdoor access to drinking water, children will use resuable cups provided by facility which will be cleaned daily and water refills will be dispensed by staff. Each classroom will have a designated part of outdoor area. Children will not commingle with other classrooms.

The following items were reviewed as part of today's visit: Record keeping for staff, children, and facility records, Care and Supervision of the Children, Child Discipline Procedures, Emergency Evacuation Procedures, Medication Policies (non-prescription medications will not be administered), Isolation of Sick Children, Napping Requirements, Food Service, Transportation (none will be provided), Parents Rights, and Reporting Requirements. Required postings were observed during today's inspection. Facility will conduct quarterly emergency drills for infant program and drills every other month for toddler classroom and a log will be maintained for review upon request. The fire inspection was conducted, and approval was received on May 25, 2021. The requirement for Lead Water Testing was discussed (H&S Code 1597.16). PIN 21-21-CCP and PIN 20-01-CCP were provided to applicant during today's inspection.

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SUPERVISORS NAME: Alma Malig
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021

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: ALL FIVE	FACILITY NUMBER: 414004790
	VISIT DATE: 08/23/2021

NARRATIVE

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LPA also provided applicant with COVID-19 technical assistance and included current COVID-19 guidance and resources to applicant. Applicant was informed that access to available Personal Protective Equipment (PPE) may be available through the local childcare resource and referral agency.

LPA will approve licensure for this facility with a capacity of 18 children effective today August 23, 2021.

Report was reviewed and discussed with Applicant Carol Thomsen. A copy of report was provided.

SUPERVISORS NAME: Alma Malig
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021

LIC809 (FAS) - (06/04)

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