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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002580
Report Date: 12/09/2022
Date Signed: 12/09/2022 12:12:19 PM

Document Has Been Signed on 12/09/2022 12:12 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:COASTSIDE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
414002580
ADMINISTRATOR:CORZINE, KARENFACILITY TYPE:
850
ADDRESS:565 REDONDO BEACH ROADTELEPHONE:
(650) 726-7416
CITY:HALF MOON BAYSTATE: CAZIP CODE:
94019
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 11DATE:
12/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Karen CorzineTIME COMPLETED:
12:25 PM
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Licensing Program Analyst (LPA) Andrea Medlin met with facility representative for this required annual licensing visit today. Purpose of visit explained. There are 11 children present during the visit. Facility meets teacher/child ratio today. Days and hours of operation: Monday-Friday 8:00AM-5:00PM. The facility has a fully charged fire extinguisher that meet the minimum requirements, smoke detectors, and a carbon monoxide (CO) detector in facility. Children's bathrooms inspected; all toilets and hand washing facilities are in safe and sanitary operating condition. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. Per director, there are no firearms or weapons on site. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Variety of age appropriate toys and materials for children is available. Classrooms are set up for child care and furniture and equipment for children is present. Adequate first aid supplies are available. Sick children will be separated from the group while waiting for parents to pick up. Facility provides snacks and meals; sample menu is posted. Children use provided cots to nap; facility provides all napping supplies and washes once a week. Outdoor play areas are inspected for health and safety hazards. The areas outside under climbing structures are cushioned with tanbark. Shade is provided by overhead tarps. Outdoor activity spaces are fully fenced and surfaces are free of hazards. Facility has posted all the required licensing forms in a prominent accessible location. LPA reviewed staff and children's records. In the children’s files reviewed, all records are complete. In the staff files reviewed, are records are complete. Staff have verification of the required mandated child abuse reporter training as compliant with AB1207. Staff have current Pediatric First Aid and CPR. Staff have verification of the required staff immunizations: measels (MMR) and pertussis (TDap).


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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Andrea Medlin
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2022
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: COASTSIDE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414002580
VISIT DATE: 12/09/2022
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Incidental Medical Services (IMS) policy discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA is 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. Facility informed that effective September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

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.

This report is reviewed with facility representative and a copy of this report must be made available for public review upon request.

Notice of Site Visit posted and shall remain posted for 30 days.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Andrea Medlin
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2022
LIC809 (FAS) - (06/04)
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