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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410518635
Report Date: 03/16/2022
Date Signed: 03/16/2022 02:12:59 PM

Document Has Been Signed on 03/16/2022 02:12 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:PALCARE CHILD CARE CENTERFACILITY NUMBER:
410518635
ADMINISTRATOR:HAAS, ALISONFACILITY TYPE:
850
ADDRESS:945 CALIFORNIA DRIVETELEPHONE:
(650) 340-1289
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY: 121TOTAL ENROLLED CHILDREN: 121CENSUS: 65DATE:
03/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lisa Kiesselbach TIME COMPLETED:
02:00 PM
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 On March 16, 2022, Licensing Program Analyst (LPA) Van met with Executive Director Lisa Kiesselbach for an unannounced annual random inspection. The purpose of the inspection was explained and granted entry to the facility by the Director. The site Director, Allison Haas, arrived during the inspection. Present today are 65 children supervised by 16 teachers. This program operates year-round The days and operations hours are Monday - Saturday from 6:00 am to 11:00 pm. The program operates in seven classrooms: Sea Lions, Sea Horses, Sea Turtles, Dolphins, Stingray, Sunfish, and the Blue Whale. The isolation area for an ill child is in the front room, and the staff will monitor and supervise the child while parents are contacted to come and pick up. The Director stated that the Center conducts fire and earthquakes quarterly, and the last drill was conducted on February 23, 2022.
LPA and the Director inspected the facility for health and safety hazards. The facility has an electronic sign-in /out for parents or authorized representatives in each classroom; sign-in/out codes are provided to the parents. All classrooms have age-appropriate toys and learning materials. Furniture appears steady and in good repair. The facility has multiple carbon monoxide detectors, a centralized smoke alarm, fully charged fire extinguishers, and working telephones. LPA observed that each child has their cubbies available with their name labeled. All emergency supplies are stored in locked storage. Medications are appropriately labeled and stored out of reach of children. First aid supplies are fully stocked and available for children's usage. Sleeping cots are appropriately stored. Per the Director, children's blankets and cot sheets are washed daily. The children's toilets and sinks are in good working condition with proper sanitation. The staff has a separate bathroom. All cleaning solutions, poisons, and other dangerous chemicals are stored in an area inaccessible to children.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2022
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: PALCARE CHILD CARE CENTER
FACILITY NUMBER: 410518635
VISIT DATE: 03/16/2022
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 The facility currently has an outdoor waiver that approved 71 children to use the outdoor at one time, and a rotational schedule is required. Outdoor play structures are age-appropriate, in good condition, and free of any loose parts. There are soft cushioning underneath all play structures to absorb accidental falls. Director stated the sandbox is inspected daily prior to children's play. LPA observed no bodies of water on the premises.
The facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). Due to COVID, the Center only provides morning, afternoon snacks, and lunch is brought from home. The menu is observed posted. The food preparation area is adequately equipped, clean, and free of hazards; this area is made inaccessible to children in care. Water pitchers and water fountains are readily available for children indoors and outdoors. All storage containers for solid waste within the Center have a proper tight-fitting cover.
Ten random children's records and personnel records were reviewed during the inspection. Records review showed the facility has records of each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record, medical assessment, and admission agreement can be located in each child's file. Staff records indicate that all staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Multiple staff members have a record of valid CPR. All staff maintained immunization records and verified the mandated child abuse reporting training as compliant with AB1207. LPA reviewed the educational qualification of the Director and staff, and all staff had the required ECE units.
The 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.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
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: PALCARE CHILD CARE CENTER
FACILITY NUMBER: 410518635
VISIT DATE: 03/16/2022
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 This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative records. 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
The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare
LPA encouraged the Director to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Director can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.
LPA obtained an up-to-date Personnel Report (LIC 500) and the Designation of Administrative Responsibility (LIC 308) during the inspection.
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.
No deficiencies are cited today. An exit interview was conducted, and the report was reviewed with the Executive Director, Lisa Kiesselbach. Today's report, March 16, 2022, and notice of site visit will be sent to the Director by email by the close of business on March 16, 2022. Confirmation of receipt is required. LPA informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
LIC809 (FAS) - (06/04)
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