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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004465
Report Date: 11/17/2021
Date Signed: 11/17/2021 03:51:28 PM

Document Has Been Signed on 11/17/2021 03:51 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:WUND3RSCHOOLFACILITY NUMBER:
414004465
ADMINISTRATOR:DOAN, MICHELLEFACILITY TYPE:
850
ADDRESS:1215 O'BRIEN DRIVETELEPHONE:
(650) 382-9388
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY: 30TOTAL ENROLLED CHILDREN: 26CENSUS: 18DATE:
11/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Michelle DoanTIME COMPLETED:
01:30 PM
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At 10:15AM, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced Annual Required inspection. LPA met with Director, Michelle Doan and explained purpose of inspection. Present in the facility were 4 staff and a total of 18 children (one toddler, and 17 preschool age). Facility has a toddler component. Facility is operating within capacity requirements on this day. All adults working in the facility have a criminal record clearance on file.
LPA and Director inspected Indoor and outdoor space for Health and Safety hazards. Facility is operating in the main classroom. LPA observed the facility to be in good repair with proper temperature and ventilation. Facility has accessible restrooms for children’s use, signage on door indicating exclusive use of the Preschool program during daycare hours.

There were a variety of age appropriate toys and equipment in the facility which were in good condition. All cleaning supplies, poisons and other chemicals were stored inaccessible to children. There was a working smoke detector and carbon monoxide detector, fire alarm, a fully charged fire extinguisher, and a working telephone. Phone number listed for facility is current. There is a fully supplied first aid kit. Per director, there are no weapons or firearms in the facility. There were no pools, spas or bodies of water on the property. Facility is enclosed with an least 3ft high fence. Outdoor toys and equipment outside were age appropriate and in good repair.

LPA reviewed children's file and employee records. Per Director, fire drill was last conducted September 17th, 2021.

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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
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)
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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: WUND3RSCHOOL
FACILITY NUMBER: 414004465
VISIT DATE: 11/17/2021
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Incidental Medical Services (IMS) policy was discussed. Facility does not offer IMS at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When 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: 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, 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 Family Child Care Home. 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.

No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations.

A notice of site visit will be emailed and must remain posted for 30 days.

An exit interview conducted and report was reviewed with the Director, Michelle Doan.
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
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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