214005616-8-2-2022-05-CC-CQUO-CGWSCM-20220802134542

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005616
Report Date: 08/02/2022
Date Signed: 08/02/2022 01:46:18 PM

Document Has Been Signed on 08/02/2022 01:46 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:	NEW VILLAGE SCHOOL, THE		FACILITY NUMBER:	214005616
ADMINISTRATOR:	DANIELSON, MITCHELL		FACILITY TYPE:	850
ADDRESS:	100 EBBTIDE AVENUE, ROOM 350		TELEPHONE:	(415) 289-0889
CITY:	SAUSALITO	STATE: CA	ZIP CODE:	94965
CAPACITY: 18	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	08/02/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Geoff & Robin Barneby		TIME COMPLETED:	02:00 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 August 2, 2022, at approximately 9:45am, Licensing Program Analyst (LPA) Catrina Quimbo conducted a pre-licensing inspection. LPA met with applicants, Robin and Geoff Barneby, and explained the purpose of the inspection. The applicant is requesting for a preschool license with a capacity of 18 children, ages 2.9 years to 4.9 years. The preschool program operates at the New Village School in Building 3, classroom 350 only. There is a separate licensed provider operating at the New Village School in Building 5. Per applicant, facilities do not co-mingle nor are related to each other. The preschool program will be called The Little Village and operates as part of the New Village School. The facility will operate Monday through Friday from 8:30am to 3:00pm. Children will be signed in and out of the facility with children's authorized representatives' written signatures. Applicant is aware sign in/out records must be made readily available for review during a future inspection. The facility was measured indoors and outdoors for heath and safety hazards and measured to calculate capacity. Indoors: The preschool program will operate out of one classroom only. The classroom was measured for 963.24 sq ft. allowing for a capacity of 27 children. LPA observed classroom to be clean, equipped with a fully charged fire extinguisher and multiple carbon monoxide detectors. All furnishings, toys, and equipment was observed to be safe, age appropriate and in good condition. Sufficient storage space for children's personal belongings are located inside the classroom. Mats will be utilized for napping children. Applicants plan to provide sheets that will be laundered on site weekly or as needed. Entire facility is adequately ventilated and free of insects and bugs. The classroom includes a kitchen/food prep area that children will use as a pass by area only. Applicants were reminded cleaning products, hazardous or sharp materials must be made inaccessible to children. Sanitation and contamination was discussed. The classroom also includes a preschool office that will be utilized for staff and children's authorized representatives. The preschool office will be used as an isolation area for sick children. Applicants were advised children using isolation area must always be supervised. (Continue on Page 2...)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NEW VILLAGE SCHOOL, THE	FACILITY NUMBER: 214005616
	VISIT DATE: 08/02/2022

NARRATIVE

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There are two bathrooms that are located inside the classroom for children's use. Staff have access to a separate restroom, outside the classroom. Children's bathrooms were observed to be clean with appropriate toileting equipment. There are 2 toilets and 2 sinks, allowing for a capacity of 30 children. Sinks accessible to children do not provide water that is warmer than 120 degrees Fahrenheit.

Program will provide a food service that includes breakfast/ morning snacks only. Children are to bring their own lunch and afternoon snacks. LPA reminded applicants children who bring their own items are to be labeled with each child's individual names. Facility plans to have children provide their own, individually labeled water containers that will be refilled at the facility. Applicant plans to also provide water pitchers with disposable cups, making water available to children both indoors and outdoors.

LPA reminded applicant to conduct and document emergency disaster drills at least one every six months.

Medications with children’s individual names and required documentation will be stored in preschool office. Medications that require refrigeration will be stored in food prep area's refrigerator. This facility plans to provide Incidental Medical Services –IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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.

Outdoor: The outdoor area is attached to preschool program. Per applicant, preschool program has exclusive use over outdoor area. The outdoor area measures for 3,009.08 sq ft. allowing for a capacity of 40 children. Entire outdoor area is enclosed with an at least 4 ft. high fence. Outdoor area was observed to be clean. Adequate shade is provided by trees and designated areas with tarp. There are no play structures in outdoor area.

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NEW VILLAGE SCHOOL, THE	FACILITY NUMBER: 214005616
	VISIT DATE: 08/02/2022

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LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Prior to recommended licensure for 27 children, following must be completed:
-Fire clearance.
-Completion of kitchen counter top installation.
-Full review by LPA.

Exit interview conducted and report was reviewed with the applicant, Robin Barneby.

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

LIC809 (FAS) - (06/04)

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