414004814-2-9-2023-05-CC-MROZ-CNVPHB-20230209101940

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004814
Report Date: 02/07/2023
Date Signed: 02/09/2023 10:19:52 AM

Document Has Been Signed on 02/09/2023 10:19 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	PACIFIC RIM INTERNATIONAL SCHOOL (INF)		FACILITY NUMBER:	414004814
ADMINISTRATOR:	CHEUNG, CHRISTINIA		FACILITY TYPE:	830
ADDRESS:	2600 CAMPUS DRIVE		TELEPHONE:	(650) 685-1881
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	02/07/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Christinia Cheung and Rita Tang		TIME COMPLETED:	05:15 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 Director Christinia Cheung and Administrative Director Rita Tang. Licensee has applied for a relocation from 454 Peninsula Ave, San Mateo, CA 94401 (license #414003003) to 2600 Campus Drive, San Mateo, CA 94403. The center will be a combination center with an infant program and a preschool program with a toddler component (under application #414004813). Licensee is requesting a total capacity of 36 infant children. Hours of operation will be Monday to Friday from 8:00am to 6:00pm. Designated site director will be Christina Cheung. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity. Indoor: Total useable indoor square footage for the Nido Room (ND) is 1,741.28 sq ft divided by 35 sq ft equals 49 children. There is a total of three toilets and eight sinks accessible for children's use (six sinks indoors and two sinks outdoors). Total allowable capacity for toilets is 45 and sinks is 120 . The Nido Room will be split into four smaller classrooms using wall partitions. Each classroom has its own crib area and changing station area. Classroom is observed today to be clean, safe, and in good repair. All furniture, toys, and equipment are observed to be age appropriate and in good condition. There is storage space for children's personal belongings and cribs and mats to be utilized for napping children. There is a fire alarm and sprinkler system throughout the facility. Classroom is equipped with a fire extinguisher and smoke and carbon monoxide detectors. Garbage cans have tight-fitting lids. First aid kit and emergency supplies are inaccessible to children. The facility is adequately ventilated and free of insects and bugs. The changing station area in each classroom has one toilet and one sink except for the first classroom you enter which only has a potty chair available. There is also two other sinks right next to each changing station area for children's use. Changing station areas are observed to be clean and with no health and safety hazards. All sinks accessible to children deliver water that is no warmer than 120 degrees. There is a separate bathroom for staff usage on the premises.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PACIFIC RIM INTERNATIONAL SCHOOL (INF)	FACILITY NUMBER: 414004814
	VISIT DATE: 02/07/2023

NARRATIVE

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Drinking water is available for children indoors and outdoors. All toxins and other hazardous items will be stored in the storage room of the classroom and will be inaccessible to children. Isolation of ill children will be in the office and the staff bathroom will be used for an ill child.

Facility will provide lunch for older infants and snacks through an in-house chef. A menu will be posted for the month by the front office. Medications will be stored in a cabinet in the kitchen area inaccessible to children. There is a designated kitchen area in each classroom where food is prepared and a working refrigerator. Refrigerated medications will be stored separately from food. Medication will be administered with parental consent and will be kept in the child’s file for record. All medication will be logged when administered to children. Required postings were observed during today's inspection.

Outdoor: Total useable outdoor square footage measures 1,100 sq ft. divided by 75 sq ft allowing a total of 15 children. The outdoor area is accessible through the classroom and is enclosed by a fence at least four feet tall. Outdoor area is observed to be clean, safe, and equipped with age appropriate toys and equipment for children. Resilient material is located on the ground of the play structure. Teachers will bring out a pitcher of water and disposable cups while outside. Shade for children will be provided by the trees and the building itself. A request for a waiver to have a rotational schedule for use of the outdoor play area will be provided to LPA.

LPA will approve the licensure of this facility with a total capacity of 36 infant children effective as of today, February 7, 2023. Fire clearance inspection was conducted and granted on March 24, 2022. Licensee will inform LPA once facility at 454 Peninsula Ave, San Mateo, CA 94401 has been closed so it can be closed out in LIS.

Facility representative was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years by all staff hired. Training can be taken online at www.mandatedreporterca.com. If training is not available in native language, a statement can be written stating exemption until the translation is available.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PACIFIC RIM INTERNATIONAL SCHOOL (INF)	FACILITY NUMBER: 414004814
	VISIT DATE: 02/07/2023

NARRATIVE

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Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) 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.

LPA reviewed with facility representative the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with facility representative Rita Tang.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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