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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005603
Report Date: 02/17/2022
Date Signed: 02/17/2022 04:48:53 PM

Document Has Been Signed on 02/17/2022 04:48 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:ROSS BRIDGESFACILITY NUMBER:
214005603
ADMINISTRATOR:GALLARDO, JENINEFACILITY TYPE:
850
ADDRESS:23 ROSS COMMON #4BTELEPHONE:
(415) 302-9601
CITY:ROSSSTATE: CAZIP CODE:
94957
CAPACITY: 10TOTAL ENROLLED CHILDREN: 10CENSUS: 0DATE:
02/17/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Tracy SalterTIME COMPLETED:
02:35 PM
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Licensing Program Analyst (LPA) Haydee Caliboso met with Tracy Salter (Assistant Director) on 02/18/22 for a pre-licensing inspection. The applicant has requested a capacity of 11 children, ages two to entry to first grade. The facility building that will be used for the program is on a commercial building called The Garage building and will operate from Monday - Friday; 8:00AM – 4:00PM. However, the program plans to provide care from 8:00AM - 1:00PM at this time. The designated Director for the facility is Jenine Gallardo. The facility was inspected today, indoor and outdoor, for health and safety hazards, and measured to calculate capacity.

Indoor: There is one classroom that will be used for the program and the following square footage was calculated for 409.06 sq. ft. allowing for a capacity of 11 children. The classrooms and furniture equipment are clean and in good condition. Children’s toys and supplies are orderly, in good condition, and age appropriate. There is storage space for children's personal belongings. Parents will provide snacks and lunch daily. The classroom is equipped with a fire extinguisher, smoke, and carbon monoxide detectors. The classroom has garbage cans with tight-fitting lids. The classroom has a designated backpack with a first aid kit and emergency supplies. There is also a first aid kit located in the front office area. Refrigerated medications will be stored separately from food. Medication will be administered with parental consent and will be kept in the child’s file for record. All medication will be logged when administered to children. The program will not be providing nap or rest/quiet time during the hours of care.

There is one sink in the classroom available for children to use. There is one bathroom and one sink accessible for children's use. The bathroom is located outside the classroom down the hall.
Cont. 809-C pg. 2
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Haydee R Caliboso
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2022
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: ROSS BRIDGES
FACILITY NUMBER: 214005603
VISIT DATE: 02/17/2022
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LPA reminded the Assistant Director that active supervision and ratio must be ensure at all times. The capacity for 1 toilet is 15, and the capacity for 1 sink is 15. The bathroom is clean and does not have any health or safety hazards. All cleaning supplies and hazardous items are stored in a locked cabinet made inaccessible to children. Isolation area for ill children is in the front or by teacher’s space area, and staff bathroom will be used for ill children. There is designated bathroom for staff to use. Children will bring their own water bottle for indoor and outdoor use. In addition, pitchers of waters will be provided for indoor and outdoor use.

Outdoor: The facility has no outdoor play area. The facility and parents in the program have submitted an open space playground waiver permit. Parents in the program are members of Marin Art & Garden Center in Marin which is 0.2 miles away from the facility. The park was inspected and meets the requirements for the open space waiver. Children will walk to the park. Teachers will bring children’s water bottles, first aid and emergency bag pack for playground use. LPA reminded the Assistant Director to ensure ratio and supervision are observed at all times. The facility will conduct and log fire drills once every six months, and the log will be available upon request.

The following items were reviewed as part of today’s visit: Record keeping for staff, children, and facility records, care and supervision of the children, child discipline procedures – staff will use positive discipline and redirection. Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements, Food Service, Transportation-none provided, Parents Rights, and Reporting Requirements.

This facility will provide Incidental Medical Services – IMS. LPA reviewed storage area for medication and equipment/supplies, and reviewed forms that will be used. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.
Cont. 809-C pg. 3
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Haydee R Caliboso
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: ROSS BRIDGES
FACILITY NUMBER: 214005603
VISIT DATE: 02/17/2022
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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

The Assistant Director was reminded about Mandated Reporter training available on the CCLD website. In addition to the AB1207 a total of 7 hrs training must be completed every two years by all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

The Assistant 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.

An electronic copy of this three-page report was emailed to Tracy Salter and Jenine Gallardo. Applicants were asked to review the report and return a signed copy of the report to LPA Haydee Caliboso.

Based on available square footage, sinks, and toilets, LPA Haydee Caliboso will recommend licensure of this facility for a maximum capacity of 11 children. The following is required prior to licensure:

· LIC 404 Financial Release and Verification
· Fire clearance approval from Ross Fire Department
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Haydee R Caliboso
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
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