414004812-1-4-2024-05-CC-LTMO-CZ6THS-20240104134513

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004812
Report Date: 01/04/2024
Date Signed: 01/04/2024 01:45:25 PM

Document Has Been Signed on 01/04/2024 01:45 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:	PRIMARY SCHOOL, THE		FACILITY NUMBER:	414004812
ADMINISTRATOR:	EASTER, KYNDAL		FACILITY TYPE:	850
ADDRESS:	2086 CLARKE AVENUE		TELEPHONE:	(650) 396-2779
CITY:	EAST PALO ALTO	STATE: CA	ZIP CODE:	94303
CAPACITY: 98	TOTAL ENROLLED CHILDREN: 95	CENSUS: 67	DATE:	01/04/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Dean of Operations, Reyna Nieto and Executive Director, Kira Lewis Clarke, ECE Dean, Tajmah Martin and Director of Operations, Nathalie Carvajal		TIME COMPLETED:	02:00 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 January 4th, 2024, at approximately 9:30am, Licensing Program Analyst (LPAs) Tapia-Mandujano and Nasiripour arrived at the facility to conduct an unannounced, annual inspection. LPA met with Dean of Operations, Reyna Nieto and Executive Director, Kira Lewis Clarke, ECE Dean, Tajmah Martin and Director of Operations, Nathalie Carvajal and explained the purpose of the inspection. Present in the facility are Administrative Staff and 15 staff caring and supervising a total of 67 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 rents from Ravenswood School District Property. Facility also has K-6th grade on site. Facility is currently operating in #3,4,5,6,7, and 12. The hours of operation are Monday-Friday from 7:30am-5:30pm. During today's inspection, LPA Tapia-Mandujano received documents by facility. LPAs observed classrooms to be clean and equipped with age appropriate toys and materials. Storage for children's belongings are located inside the classrooms, labeled with each child's individual names. LPAs observed facility has an installation of a fire alarm system inside each classroom as well as a fully charged, fire extinguishers located inside each classroom. The classrooms have a smoke and carbon monoxide detector installed as well as emergency kits with first aid materials and emergency contact information in each classroom. Per facility, there are currently children enrolled with prescribed medication. Facility has a plan in place to properly store Medication (medication is stored in the Nurse's office), inaccessible to enrolled children and each classroom is maintained with proper documentation. All poisons, cleaning solutions and hazardous materials are stored inaccessible to children in off limit areas or facility high shelves. Facility offers breakfast, lunch, and snacks through Ravenswood School District. Menus are posted outside each classroom. Water is available to children indoors and outdoors. Continued on Page 2..

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

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: PRIMARY SCHOOL, THE	FACILITY NUMBER: 414004812
	VISIT DATE: 01/04/2024

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, as well as in each classroom for parents to review. There are no pools or bodies of water on the promises. Per facility, children will occasionally have water play with supervision and the water is emptied out after each use.

LPAs reviewed facility records that included 6 children's records and 6 staff records. LPAs observed children's records to be complete. LPAs observed that staff records are missing some documents (Technical Violation was left). There was at least one staff who has an up to date CPR & First Aid certificate. As well as all staff have up to date Mandated Reporter Certificate. Last emergency drill was conducted 12/2023. 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: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: PRIMARY SCHOOL, THE	FACILITY NUMBER: 414004812
	VISIT DATE: 01/04/2024

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. Facility will develop a plan and email it to LPA Tapia-Mandujano. 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.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. Facility has been retested and is awaiting results. Waiver for extenstion has been approved.

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, no 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 LPA met with Dean of Operations, Reyna Nieto and Executive Director, Kira Lewis Clarke, ECE Dean, Tajmah Martin and Director of Operations, Nathalie Carvajal.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

LIC809 (FAS) - (06/04)

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