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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700745
Report Date: 08/06/2021
Date Signed: 08/06/2021 03:33:47 PM

Document Has Been Signed on 08/06/2021 03:33 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:STANFORD WEST CHILDREN'S CENTERFACILITY NUMBER:
435700745
ADMINISTRATOR:LARSEN, NATHALIEFACILITY TYPE:
850
ADDRESS:625 CLARK WAYTELEPHONE:
(415) 994-8040
CITY:PALO ALTOSTATE: CAZIP CODE:
94304
CAPACITY: 90TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/06/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Nathalie LarsenTIME COMPLETED:
03:40 PM
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A Prelicensing Visit was conducted today by Licensing Program Analyst (LPA), Melanie Otsuji. LPA met with Applicant, Nathalie Larsen. The applicant has submitted an application for a PRESCHOOL license. A health and safety inspection was conducted inside and outside. The preschool program will operate in 5 classrooms (Garden/Rm 123, Meadow/Rm119, Willow/Rm 118, Forest/Rm 113, Redwoods/Rm 109, and lounge area. Also on site is an Infant Component operating out of 2 classrooms. Operating hours Monday through Friday from 7:00AM - 6:00PM. The measurements are as follows:

INDOORS: 3227.79 square feet = 92 children
OUTDOORS: 4445.76 square feet = 59 children

Measurements were taken of each room and of the out door play yard. There are two separate staff bathrooms and one will be utilized for an isolation restroom if a child becomes ill. A waiver and a yard schedule was submitted for yard space never to exceed more than 59 children on the yard at one time. There is a fully stocked first aide kit with all required equipment available and a locked box for stored medications. The kitchen is kept off limits by a closed door. No exit doors were blocked. There is ample toys and furnishings throughout the center for children's use. There are cots and mats available for children.

There are 8 toilets ( sized appropriately) and 11 sinks available for children's use. Heating and lighting was adequate. There is a play structure in the play yard and it is cushioned with artificial turf. The center Director will be Javanni Austin-Brown and a directors packet with all required documentation was submitted to CCL to complete the application. There is an approved fire clearance signed on 8/4/2021 for 90 children.


Report continued on 809C
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2021
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: STANFORD WEST CHILDREN'S CENTER
FACILITY NUMBER: 435700745
VISIT DATE: 08/06/2021
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There are no bodies of water nor hazards found on the premises. Playground equipment is in good condition. Drinking water is available inside and outside. All toilets and handwashing facilities are in safe and sanitary operating conditions. All licensing required documents are posted. This facility plans to provide Individual Medical Services – IMS. An updated 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

A license for 90 preschoolers operating out of 5 classroom (Garden/Rm 123, Meadow/Rm 119, Willow/Rm 118, Forest/RM 113 and the lounge area) recommended effective today, 8/6/2021.

An exit interview was conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
LIC809 (FAS) - (06/04)
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