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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430700496
Report Date: 11/17/2021
Date Signed: 11/17/2021 01:04:51 PM

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:PALO ALTO FRIENDS NURSERY SCHOOLFACILITY NUMBER:
430700496
ADMINISTRATOR:VANIDES, JANETFACILITY TYPE:
850
ADDRESS:957 COLORADO STTELEPHONE:
(650) 856-6152
CITY:PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY:38CENSUS: 16DATE:
11/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Heather Barberena TIME COMPLETED:
01:15 PM
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On 11/17/2021 at 9:30AM Licensing Program Analyst (LPA) Sabina Dodoo and Licensing Program Analyst(LPA) Jonathan Williams, met with Assistant Director Heather Barberena for an UNANNOUCED ANNUAL REQUIRED INSPECTION. Present for the inspection were 6 teachers who are all fingerprint cleared and associated.The total children enrolled are 38 and the census was 16 at the time of the inspection. The classroom is within ratio. LPAs provided licensee a copy of form LIC 125. The Child Care Center was toured to conduct a Health and Safety Inspection. The facility currently operates Monday through Friday from 9am to 1pm.

The Child Care Center is a single-story school with a fenced play yard in the back. There are two classrooms: SUNSHINE ROOM AND BLOCK ROOM. There are chairs and tables equipped for children. The sink has pumping soap and paper towels to dry hands. LPAs(Williams and Dodoo) observed the classrooms to be neat with proper ventilation and materials equipped to care for the children. The assistant director allows the parents to enter through the front gate of the school after temperatures are checked and hands are washed. There is a multipurpose room that is used if it is a rainy day for teachers to have children complete activities or do circle time. LPAS (Sabina and Jonathan) observed the bulletin board (parent’s rights, emergency disaster, earthquake drills and facility license). There are no menus posted due to the school not providing food to the children. The parents sign in and out through an app called Jovial. The backyard area is fenced with sand all around the play structure to help absorb falls. There is also a sandbox, benches, bikes, and a play house.

The OFF-LIMIT AREAS are the office and the kitchen.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 7
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: PALO ALTO FRIENDS NURSERY SCHOOL
FACILITY NUMBER: 430700496
VISIT DATE: 11/17/2021
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The ON-LIMIT AREAS are the play yard which is fenced with a gate that opens inward/ outward and all the classrooms. The classroom has safe furniture appropriate for children. There are no sleeping cots due to the school only having a short morning program until 1pm. The trash bins are not covered with a lid and a Technical Advisory TA was given to the facility. All the disinfectants and cleaning solutions are stored in the top shelves in the bathroom, so the children do not have access to them. The children bring food and water from home with their names on them. Water is also provided for the children on an as needed basis. If children are hungry there are goldfish snacks the teachers can provide to the children. The classroom is equipped with toys, books, chairs, and tables that are appropriate for the age group. The children have cubbies with their names on them.

All hazardous materials and toxins are kept out of reach from children and are not accessible. The Child Care Center has a fully charged fire extinguisher 3A-40-BC, working smoke detector, working carbon monoxide, telephone and fully stocked first aid kits. The furniture around the classroom is child proof and the toys are stored in safety bins that can be easily accessed by the children. A Technical Violation TV was given to the facility for mandated reporter training missing in the files of the staff members. The assistant director has been advised to ensure all staff have current mandated reporter training within 3 business days.

The Assistant Director has completed the Health and Safety training, CPR/First Aid is current. The licensee is following the immunization laws and has completed the mandated reporter training. The director conducts and documents fire and disaster drills twice a year and the last conducted drill was on 09/17/2021. All required forms are posted and visible for public view.

At 11:30AM LPA (Jonathan Williams) reviewed 10 children’s files and LPA (Sabina Dodoo) reviewed 6 staff files, facility file and documented on LIC 857 and LIC 859. There is a current roster available for review and copy obtained. The staff interview was completed with the Center Assistant Director Heather Barberena at 12:00PM.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC809 (FAS) - (06/04)
Page: 2 of 7
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: PALO ALTO FRIENDS NURSERY SCHOOL
FACILITY NUMBER: 430700496
VISIT DATE: 11/17/2021
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Incidental Medical Services (IMS) policy was discussed. This facility provides IMS to children at this time. any IMS is provided, a Plan for Providing 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

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.

Licensee was reminded that all adults 18 and over working in Child Care Center, 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 licensed 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: PALO ALTO FRIENDS NURSERY SCHOOL
FACILITY NUMBER: 430700496
VISIT DATE: 11/17/2021
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Licensee was reminded of the responsibility as a mandated reporter and the trainings must be done once every two years as well as CPR/First Aid needs to be renewed every two years and must be EMSA approved. LPA also encouraged licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded. For licensing updates and Quarterly Child Care Distribution email, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

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.

There are three technical violations/ advisory cited today. A notice of site visit was given and must remain posted for 30 days. Exit Interview and staff interview conducted with Assistant Director (Barberena) at 12:50pm. This report shall remain on file for the next 3 years.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC809 (FAS) - (06/04)
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