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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414434
Report Date: 02/25/2022
Date Signed: 02/25/2022 02:23:38 PM

Document Has Been Signed on 02/25/2022 02:23 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:STEPPING STONES PRESCHOOL & INFANT CAREFACILITY NUMBER:
434414434
ADMINISTRATOR:LINDER, KELLYFACILITY TYPE:
850
ADDRESS:201 COVINGTON ROADTELEPHONE:
(650) 559-1764
CITY:LOS ALTOSSTATE: CAZIP CODE:
94024
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 27DATE:
02/25/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Margaret MuilenburgTIME COMPLETED:
02:45 PM
NARRATIVE
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On 02/25/2022 at 10:30AM, Licensing Program Analysts (LPA) Christina Uribe & Jaylena Miller conducted an unannounced complaint investigation visit and met with facility representative, Margaret Muilenburg. As LPAs toured the facility and reviewed personnel files, it was discovered that one present staff member did not have an eligible background clearance and was not associated to the facility. LPA Uribe had contacted the department's regional office and confirmed that the staff member had a "closed - determination" application on the Guardian website resulting in no clearance to be present in the facility. This results in a Type A Violation and the issuance of an immediate civil penalty of $500.00 being cited today.

LPAs Uribe & Miller informed facility representative Margaret Muilenburg that this report dated 02/25/2022 documents one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk to the health, safety, or personal rights of children in care.

Also, LPAs Uribe & Miller informed the facility representative to provide a copy of this licensing report dated 02/25/2022 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the facility representative, Margaret Muilenburg.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2022
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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Document Has Been Signed on 02/25/2022 02:23 PM - It Cannot Be Edited


Created By: Christina Uribe On 02/25/2022 at 02:00 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: STEPPING STONES PRESCHOOL & INFANT CARE
FACILITY NUMBER: 434414434

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/25/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/25/2022
Section Cited
CCR
101170(e)(1)

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(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department
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Staff member was immedaitely removed from the facility to perform another fingerprint LiveScan and will remain off the premises until a background check has been cleared. Clearing the deficiency immediately in the presence of LPAs Uribe & Miller.
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This requirement is not met as evidenced by:

Based on record review, the licensee did not comply with the section cited above in that one staff member did not have an eligible criminal background clearance which poses an immediate health, safety or personal rights risk to persons in care.
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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: 02/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022


LIC809 (FAS) - (06/04)
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