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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004891
Report Date: 08/03/2022
Date Signed: 08/11/2022 03:55:19 PM

Document Has Been Signed on 08/11/2022 03:55 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:CHAI PRESCHOOLFACILITY NUMBER:
414004891
ADMINISTRATOR:MARCUS, ESTHERFACILITY TYPE:
850
ADDRESS:115 MONTE DIABLOTELEPHONE:
(650) 483-8350
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 0DATE:
08/03/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Esther MarcusTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Marie Rodriguez conducted a scheduled pre-licensing inspection to facility and met with Applicant Esther Marcus. Applicant is requesting a capacity of 90 preschool aged children (ages 2 years old to entry into first grade). The facility will operate from Monday to Friday from 8:00 am to 5:30 pm. The designated director/site supervisor for the facility is Esther Marcus. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity.

Indoor: Facility is inside a two story building. Facility is located on the first floor and has six classrooms and two outdoor space areas. Total useable indoor square footage of the six classrooms is 3,742.93 sq ft divided by 35 sq ft equals 106 children. There is a total of eight toilets, one urinal, and nine sinks accessible for children's use. Total allowable capacity for toilets is 135 and sinks is 135 .

Each classroom is observed today to be clean and all furniture, toys, and equipment are observed to be safe and in good condition. There is storage space for children's personal belongings and cots to be utilized for napping children. There is a fire alarm and sprinkler system throughout the facility. Each 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 located in each classroom inaccessible to children. The facility is adequately ventilated.

Bathroom located between toddler classrooms 1 and 2 (2 year olds) has three toilets and three sinks. Bathroom located between preschool classrooms 1 and 2 has three toilets and three sinks. Bathroom located between preschool classrooms 3 and 4 has two toilets and one urinal. The bathrooms are observed to be clean and with no health and safety hazards. All sinks accessible to children in each classroom deliver water that is no warmer than 120 degrees. There is a separate bathroom for staff usage on the premises. Drinking water is available for children indoors and outdoors. All toxins and other hazardous items will be stored in high cabinets in 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.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/03/2022
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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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: CHAI PRESCHOOL
FACILITY NUMBER: 414004891
VISIT DATE: 08/03/2022
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Facility will only provide morning and afternoon snacks. Children will bring their own lunch. Medications will be stored in a cabinet in each classroom inaccessible to children. Required postings were observed during today's inspection.

Outdoor: There are two outdoor areas at the facility. One outdoor area is located next to toddler classrooms 1 and 2. Entry to this outdoor area is only available through the toddler classrooms. This outdoor area measures 1,323.22 sq ft. divided by 75 sq ft allowing for a total of 17 children. Facility has a set schedule for each classroom to use the outdoor area at specific times. Outdoor space waiver request will be submitted and a copy of outdoor play schedule will be provided. The outdoor area is enclosed by a fence over four feet tall and 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 area. There is also a sandbox that will be covered when not in use. Teachers will bring out children's reusable cups filled with water while outside. Shade for children will be provided by shade awnings above the entrances of the toddler classrooms and the building itself.

Second outdoor area is located next to preschool classrooms 1-4. Each classroom has a door leading into the outdoor play area. This outdoor area measures 5,261.02 divided by 75 sq ft allowing for a total of 70 children. The outdoor area to be used is enclosed by a fence over four feet tall and 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 area and underneath the play structure. Play structure is age appropriate for children in care. There is also a sandbox that will be covered when not in use. Teachers will bring out children's reusable cups filled with water while outside. Shade for children will be provided by the building and shade awnings next to classrooms 3 and 4. Outdoor play area has two emergency exit doors that will be locked and secured.

LPA will approve licensure of facility for the capacity of 90 children once fire clearance has been granted by Fire Inspector. Fire clearance inspection is scheduled for August 5, 2022 at 9am.

Licensee 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: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022
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: CHAI PRESCHOOL
FACILITY NUMBER: 414004891
VISIT DATE: 08/03/2022
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Applicant 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 applicant 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 [applicant, licensee, or 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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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 applicant 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 the applicant Esther Marcus.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022
LIC809 (FAS) - (06/04)
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