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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400202
Report Date: 06/14/2024
Date Signed: 06/14/2024 03:07:23 PM

Document Has Been Signed on 06/14/2024 03:07 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:WHISTLE STOP, THEFACILITY NUMBER:
434400202
ADMINISTRATOR/
DIRECTOR:		VALERIE ROUTTFACILITY TYPE:
850
ADDRESS:3801 MIRANDA AVENUE #T6BTELEPHONE:
(650) 852-3497
CITY:PALO ALTOSTATE: CAZIP CODE:
94304
CAPACITY: 53TOTAL ENROLLED CHILDREN: 27CENSUS: 21DATE:
06/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Valerie RouttTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
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On 06/14/2024 at 10:00am, Licensing Program Analysts (LPAs) Christina Uribe & Jialing "Julianne" Zhu conducted an Unannounced Annual Required Inspection. LPA met with site director, Valerie Routt, also present at the time of the inspection were 5 staff & 21 children. The facility is within ratio & capacity compliance today. LPA provided facility representative the Entrance Checklist (LIC 125). The facility was toured to conduct a Health and Safety inspection. The facility currently operates 6:00am-5:30pm, Monday-Friday in two classrooms.

Classrooms: All classrooms were inspected for age-appropriate furnishings, equipment, & adequate storage for children’s belongings. LPA observed the cleanliness of floors & surfaces, the presence of a fully functional carbon monoxide detector, smoke detector/fire alarms, and a fully charged 3A40BC fire extinguisher that is accessible throughout the facility. The center is equipped with a fully stocked first-aid kit and available in the classrooms. LPA inspected the napping equipment and observed them to be stored in a healthful manner.

Food Service Areas: All center provided food items are properly labeled & stored separately from cleaning supplies. Food prep area is clean, adequately equipped, & free from hazardous materials. Snack menus are posted and were reviewed. Solid waste bins are equipped with tight fitting lid.

Bathrooms: Facility has separate staff and child designated bathrooms. Toilets and faucets are in safe and sanitary operating condition. The children are able to reach the sinks, toilets, and supplies.

Outdoor Play Area: The playground outside is fenced and all equipment and surfaces are free from hazards. There are no bodies of water, or free-standing water accessible to children. There are age-appropriate outdoor toys and materials for the children. The play structure is securely installed into the ground. The ground surrounding the play structure is sufficiently padded and in good condition for safety.

Page 1 of 3 ***Continued on LIC 809C***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2024
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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Document Has Been Signed on 06/14/2024 03:07 PM - It Cannot Be Edited


Created By: Christina Uribe On 06/14/2024 at 12:48 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
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: WHISTLE STOP, THE
FACILITY NUMBER: 434400202

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above as the facility has not met the requirement to perform lead testing on all faucets used for drinking and food preparation which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/15/2024
Plan of Correction
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Director will schedule for a licensed water sampling technician to come to the facility to perform lead testing. Director will email proof of this scheduled appointment to LPA Uribe at christina.uribe@dss.ca.gov no later than the due date of 07/15/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Chandra Charles
LICENSING EVALUATOR NAME:Christina Uribe
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2024


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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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: WHISTLE STOP, THE
FACILITY NUMBER: 434400202
VISIT DATE: 06/14/2024
NARRATIVE
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Records: All individuals subject to criminal record review have a clearance and have been associated to the facility. LPA reviewed 6 children’s files and 6 staff files. LPA Uribe reviewed transcripts and signed the Evaluation of Teacher Qualifications (LIC 9095) form for 4 staff members. LPA reviewed the facility roster & personnel report and copies were obtained. At least one opening/closing staff member has a current Pediatric CPR/First-Aid Certification. Mandated Reporter certificates were reviewed. Director’s CPR/First-Aid Certificate is current and expires on 10/09/25. Director was reminded of their responsibility to renew CPR/First Aid and Mandated Reporter certificates every two years. The center is in compliance with sign in and out procedure. Emergency Drills are performed at least every six months. Per facility representative, there are no firearms on the premises. All required documents are posted in a publicly accessible area.

CCLD Inspection Process: To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Criminal Record Clearance: Director 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.

Lead Testing: 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. LPA referred director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

MyChildCarePlan.org: Director 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.
Page 2 of 3 ***Continued on LIC 809C***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: WHISTLE STOP, THE
FACILITY NUMBER: 434400202
VISIT DATE: 06/14/2024
NARRATIVE
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Incidental Medical Services (IMS): This facility does provide Incidental Medical Services (IMS). LPA inspected storage of medications and equipment/supplies, and reviewed children’s, personnel, and administrative records. All children’s medications were inspected to ensure that they are securely stored, accompanied by their original packaging, and are in compliance with expiration dates. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/resources/child-care-centers/.

Unusual Incident/Student Injury Report: Effective August 1, 2003 California Law requires Child Care Licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury Form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624, within 7 business days.

One (1) Deficiency and Five (5) Advisory Notes issued during today's inspection:

  • Type B Violation: Facility has not fulfilled the requirement to test all faucets used for drinking and food preparation for lead which was due by 01/01/2023.
  • Advisory Note (TV): The snack menu must reflect the planned food to be served to children for each day.
  • Advisory Note (TV): Some children's sign in and out forms are filled out by the parents/guardians incorrectly.
  • Advisory Note (TV): Emergency Drills are performed regularly but are not recorded as required.
  • Advisory Note (TV): Some children's Consent for Emergency Medical Treatment form are incorrect.
  • Advisory Note (TV): One child's non-prescription medication does not have the original package.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were given and reviewed. Exit interview conducted and report was reviewed with the site director, Valerie Routt.

Page 3 of 3 ***End of Report***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
LIC809 (FAS) - (06/04)
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