435700718-5-10-2023-52-CC-MMAW-CRPVDQ-20230510162106

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700718
Report Date: 05/10/2023
Date Signed: 05/10/2023 04:21:15 PM

Document Has Been Signed on 05/10/2023 04:21 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	BUILDING KIDZ PALO ALTO		FACILITY NUMBER:	435700718
ADMINISTRATOR:	PATEL, VIBHUTI		FACILITY TYPE:	850
ADDRESS:	415 LAMBERT AVENUE		TELEPHONE:	(650) 224-2144
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	96	CENSUS: 42	DATE:	05/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Priya Sudharsan/Vibhuti Patel		TIME COMPLETED:	04:35 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 5/10/2023 at 2:00 PM, Licensing Program Analyst (LPA) Michael Mathew conducted an unannounced Annual/Random inspection. LPA conducted the Covid-19 screening questions prior to entering the facility. LPA met with directors Priya Sudharsan and Vibhuti Patel and advised them the purpose of the inspection. LPA was provided a tour of the facility inside and out. There were 42 children in care and 6 staff at the time of the inspection. LPA observed required licensing documents mounted on the walls throughout the facility. LPA observed the center menu schedule which the facility provides morning and afternoon snack, and children brings lunch from home. Fire drill was last conducted on 4/11/23. The center has six (6) classroom available. At the time of inspection, 3 classrooms were in use. LPA observed enough restrooms available for children in care. LPA did not observe any hazards/toxins items accessible to children in care. There are no guns/weapons or ammunition at the facility. LPA observed no bodies of water. Each of the classrooms have age-appropriate toys and furniture readily accessible for children. Facility provides children sleeping mats during nap time. The outdoor playground has ample amount of space for children to play. LPA observed soft rubber padding under the play structure to help protect the children. LPA observed the playground has age-appropriate toys and structures available for children to use. The playground has an ample amount of shade available. Facility provides water, and the children have water bottles with their names on it for use. A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. Currently the facility does have children that require Incidental Medical services (IMS). LPA observed IMS is stored in a cabinet inaccessible to children in care. LPA also observed correct IMS document in children's file LPA observed staff files to be incomplete. LPA observed one staff members with a expired mandated reporter training certificate, LPA also observed one staff member with a valid and updated CPR training certificate. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. LPA spoke with director about new Covid-19 guidelines. Facility is currently following Covid-19 guidelines. Continued 809-C

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: 510-292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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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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: BUILDING KIDZ PALO ALTO	FACILITY NUMBER: 435700718
	VISIT DATE: 05/10/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation interpretations and procedures for Child Care Centers sections 101173 and 101226. When any IMS is provided, an updated plan of operation that includes IMS must be submitted to the Department. the follow 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

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.

PIN 22-06-CCP: Lead Testing in Child Care Centers – Frequently Asked Questions and Information on Lead Toxicity Prevention and Water Testing Information was discussed to directors Priya Sudharsan and Vibhuti Patel

Director was reminded that all adults 18 and over, 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.

one type B deficiency was cited in todays visit

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, appeal rights were given, and report was reviewed with directors Priya Sudharsan and Vibhuti Patel

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: 510-292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/10/2023 04:21 PM - It Cannot Be Edited

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: BUILDING KIDZ PALO ALTO	FACILITY NUMBER: 435700718
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and (record review, the licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.LPA observed one staff members with a expired mandated reporter training certificate, director stated that Staff forgot to update mandated reporter training.
	POC Due Date: 05/15/2023
	Plan of Correction
1 2 3 4	Director agreed to send completed mandated reporter training certificate to LPA via email or text by end of day Monday 5/15/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: 510-292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

LIC809 (FAS) - (06/04)

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