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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005146
Report Date: 09/06/2024
Date Signed: 10/14/2024 02:21:28 PM

Document Has Been Signed on 10/14/2024 02:21 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:REDWOOD CHURCH PRESCHOOLFACILITY NUMBER:
414005146
ADMINISTRATOR/
DIRECTOR:		KAREENA CAMPBELLFACILITY TYPE:
860
ADDRESS:901 MADISON AVENUETELEPHONE:
(650) 562-7611
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 82TOTAL ENROLLED CHILDREN: 82CENSUS: DATE:
09/06/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Kareena CampbellTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
NARRATIVE
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On September 6, 2024, at approximately 1:30pm, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted a pre-licensing visit to Redwood Church Preschool program. LPA met with Director Kareena Campbell and explained the purpose of the visit. LPA inspected toddler classroom that is to be added to preschool license.

Program is currently licensed for a preschool program with a capacity of 82 children through facility 4140041604. Applicant requested to add a toddler option component to licensed program. Applicant requested to add 12 toddler option children (18 months to 36 months) with 70 preschoolers (2 yrs. to 5 yrs. old).

Toddler option request was submitted to office August 14, 2024. As of this date, fire clearance has not yet been received. LPA inspected facility for health and safety hazards and measured space to calculate capacity.

Director was reminded preschool children and toddler option enrolled children must be kept physically separate and cannot commingle. Director was also reminded toddler option children must have written permission/consent from their authorized representatives to participate in toddler option component.

Indoors: Facility will be using a room previously used for after school program. Classroom is located in a portable classroom that is divided into two separate rooms with a wall a door is located between the classrooms. The toddler option classroom is room #B and was measured for 423.97 sq. ft. allowing for a capacity of 12 children. The total indoor square footage equals 423.97 sq. ft. allowing for a total capacity of 12 children.

Cont. page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 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: REDWOOD CHURCH PRESCHOOL
FACILITY NUMBER: 414005146
VISIT DATE: 09/06/2024
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The toddler areas were observed to be well ventilated with appropriate temperature. Flooring in classroom includes laminate flooring, rugs, and foam mats. LPA observed flooring in classroom to be clean. Garbage bins in facility were observed to have tight fitting lids. Classroom includes appropriate toys and materials that were in good condition.

Classroom is equipped with a fully charged fire extinguisher, first aid backpacks and a fire alarm system. LPA observed carbon monoxide detector to be in working condition. There are sufficient storage cubbies for children to store belongings located inside the toddler classroom. Classroom is equipped with toys, books, toys, and furniture that was observed to be in good repair and age appropriate. LPA did not observe any accessible poisons, cleaning solutions in the area. LPA observed electrical outlets in facility to be made inaccessible with child safety covers.

Medications with children's individual names and required documentation will be stored in upper cabinet located in toddler classroom. There is a refrigerator in classroom A to store snacks and children’s lunch if necessary.

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) tollfree 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, available at: http://www.ada.gov/childqanda.htm.

Toddlers will use sleeping cots for napping and cots will be stored in classroom A. LPA reminded director children's sheets must be stored so that they are not touching each other.

Per Director, classroom will be equipped with portable potty chairs for potty training toddlers. There is a diaper changing table that is within arm's reach to an adult sink for diapering children.

The requirement for Lead Water Testing was discussed (H&S Code 1597.16). LPA advised applicant to review PIN 21-21-CCP.

Cont. page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024
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: REDWOOD CHURCH PRESCHOOL
FACILITY NUMBER: 414005146
VISIT DATE: 09/06/2024
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Applicant was reminded emergency disaster drills are to be conducted monthly and documented. Program signs children into and out of program by children's authorized representatives' electronic signatures. Printed sign in/out sheets are available if needed.

Outdoors: Is located in front of building #3 and completely enclosed and surrounded with a 3 ft fence chain linked fenced. Outdoor play area is equipped with artificial grass to cushion falls. There are plenty of age-appropriate toys and a sand box area. The outdoor area was measured for 1057.7 sq. ft. allowing for a capacity of 14 children. The total outdoor square footage equals 1057/7 sq. ft. allowing for a total capacity of 14 children. LPA reminded Director toddler capacity is not to exceed 12 children, indoor or outdoors.

LPA reviewed with director, the LIC311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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, 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.

Cont. page 4...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024
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: REDWOOD CHURCH PRESCHOOL
FACILITY NUMBER: 414005146
VISIT DATE: 09/06/2024
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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-andresources/safe-sleep as an additional resource. LPA also informed applicant and director 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. LPA reminded Director to keep 15 minute sleep logs for all children under the age of 24 months.

Based on visit today, the preschool program licensed classroom will allow for 70 preschool age children in

same classroom previously licensed and toddler component will be added to classroom B for 12 toddler children.

LPA will approve toddler option component with preschool license when following is complete:

-Fire inspection clearance
-installation of locking mechanism to outdoor gate.

Exit interview conducted and report was reviewed with Director, Kareena Campbell.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024
LIC809 (FAS) - (06/04)
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