Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002877
Report Date: 12/21/2018
Date Signed: 12/21/2018 12:23:59 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:PFS-BAYSHORE MIDWAY CDC (PS)FACILITY NUMBER:
414002877
ADMINISTRATOR:MARISOL OSTORGAFACILITY TYPE:
850
ADDRESS:45 MIDWAY DRIVETELEPHONE:
(415) 330-1717
CITY:DALY CITYSTATE: CAZIP CODE:
94014
CAPACITY:95CENSUS: 59DATE:
12/21/2018
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Marisol OstorgaTIME COMPLETED:
10:30 AM
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# 1 Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection. LPA met with the site director, Marisol Ostorga. The purpose of the inspection was explained to her. There were 59 children with 15 staff present. The facility was running the holiday event during the inspection. Parents and volunteers were coming in & out during the inspection, This facility is located in the combination center with infant and preschool programs. The operation hours are Monday to Friday from 7am to 5:45pm. The preschool program runs in Classrooms #3, 4, 5, 6, and 7. LPA toured and inspected the facility for health and safety hazard. Room #3 (Early Pre) , Room #4 & #5 (Pre-K), Room #6 (State Preschool), and Room # 7 (Preschool classroom) . The facility was clean and in order. Temperature and lighting were adequate. All toxins items and harmful objects were locked and made inaccessible to children. Rm #3, #5, #6, and #7 had an adjacent bathroom inside of each classroom. Rm #4 children go to the children's bathroom in Room #3. Separate bathroom for staff was available in the center. Cubbies were available for children in each classroom. Mechanical Door Charms were installed at the doors in each classroom to prevent children run away. Cots with children's names were available for napping. There were plenty of age appropriate toys, books, learning materials, and children furniture available for children in each classroom. First Aid supplies and medication boxes were available in each classroom. Water was served in pitcher with cups in each classroom. This facility provides breakfast, lunch and snacks that are provided and delivered by Chefable. There are 2 outdoor play yards. Classroom # 6 has its own outdoor plays. The yards were completely fenced. There were plenty of age appropriate outdoor toys, ride-on toys, and play structure with Wood chips as soft cushioning underneath to prevent injury. All required postings were posted. Fire Drill has been conducted monthly. The latest drill was conducted in 11/2018. At least one staff had current CRP/First Aid training available in the center. It will expire in 12/2018. This facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative record. For IMS Information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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. Children roster was reviewed and a copy of it was obtained by the LPA during the inspection. Sign in/out sheets were reviewed during inspection. All staff have completed the Child Abuse Mandated Reporter Training. Certificates were reviewed during the inspection.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2018
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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