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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004862
Report Date: 05/03/2023
Date Signed: 05/03/2023 04:34:06 PM

Document Has Been Signed on 05/03/2023 04:34 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LA SCUOLA INTERNATIONAL SCHOOL-PENINSULAFACILITY NUMBER:
414004862
ADMINISTRATOR:BALFOUR, BEATRICEFACILITY TYPE:
850
ADDRESS:951 O'CONNOR STREETTELEPHONE:
(650) 800-9650
CITY:EAST PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY: 120TOTAL ENROLLED CHILDREN: 17CENSUS: 10DATE:
05/03/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Director, Beatrice BalfourTIME COMPLETED:
05:00 PM
NARRATIVE
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On May 3rd, 2023 at approximately 1pm, Licensing Program Analyst, (LPA) Tapia-Mandujano arrived at the facility to conduct an inspection and met with Director, Beatrice Balfour. Present in the facility are Director and three staff supervising 10 preschool age children. Facility is operating within capacity limits. All adults in the facility are fingerprint cleared and associated.

Upon inspection of the facility, LPA observed that the facility was operating in rooms that were not fully approved by the department. LPA observed that children were napping in Building A in Room #1. Per interview with Director, it was stated that all rooms in Building A are periodically used.

On 3/10/22, facility had a prelicensing inspection. Upon that inspection, the following was stated: "Classrooms in Building A will not be operating at this moment. Room #1 in building B will not be in operation. Room #2 and 3 will operate until enrollment increases. Prior to use of any other rooms, facility must notify department for approval."

LPA conducted a health and safety risk inspection of all classrooms in Building A. Rooms appear to be clean and have age appropriate toys and furniture, as well as safety equipment needed to meet the needs of children. LPA has approved Rooms #1-#3 in Building A as of today, May 3rd, 2023.

NEW DAYCARE AREAS ARE: Building A (Rooms #1-#3), Building B (Rooms #2-#3) and Outdoor areas both in the front and back of the buildings.

Due to a potential health and safety risks for lack of supervision, a Type B deficiency has been issued. Please see LIC 809D for more details.

This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit. An exit interview was conducted with Director, Beatrice Balfour.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2023
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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Document Has Been Signed on 05/03/2023 04:34 PM - It Cannot Be Edited


Created By: Leslit Tapia-Mandujano On 05/03/2023 at 04:04 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: LA SCUOLA INTERNATIONAL SCHOOL-PENINSULA
FACILITY NUMBER: 414004862

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
05/03/2023
Section Cited
CCR
101212(c)

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101212(c): Reporting Requirements: (c): The licensee shall notify the Department in writing of his/her intent prior to making any structural changes...of indoor or outdoor activity space. Such structural changes shall include, but not be limited to, room additions.

This requirement was not met as evidenced by:
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LPA has inspected Rooms #1-#3 in Building A. Rooms appear to be clean and have age appropriate toys and furniture, as well as safety equipment for the children in use.

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Based on observations and interview, the licensee did not comply with the section cited above as children were observed to use rooms that were not fully approved by the department, which poses a potential health, safety or personal rights risk to persons in care.
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LPA has approved Rooms #1-#3 in Building A as of today, May 3rd, 2023.

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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:Ali Zebila
LICENSING EVALUATOR NAME:Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023


LIC809 (FAS) - (06/04)
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