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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004908
Report Date: 08/09/2022
Date Signed: 08/09/2022 02:33:31 PM

Document Has Been Signed on 08/09/2022 02:33 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:AFTERSCHOOL CARE ENRICHMENT (ACE) @ ARUNDELFACILITY NUMBER:
414004908
ADMINISTRATOR:PUCCINELLI, NICHOLASFACILITY TYPE:
840
ADDRESS:200 ARUNDEL ROADTELEPHONE:
(650) 921-2948
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY: 90TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/09/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Eve Daskalakis & Victoria RuizTIME COMPLETED:
03:00 PM
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On August 9, 2022 at approximately 1:05pm, Licensing Program Analyst (LPA) Catrina Quimbo, conducted an announced, pre-licensing inspection. LPA met with applicant, Eve Daskalakis, and director, Victoria Ruiz. The purpose of the inspection was explained. The applicant is requesting a school age license for 90 children (Tk to 5th grade).The facility will operate Monday through Friday from 7:30am to 9:30am, 1:25pm to 6:00pm and Wednesdays 12:25pm to 6:00pm.

The after school program will operate on Arundel Elementary school site of San Carlos school district. The designated director of the site will be Victoria Ruiz. Fire clearance was obtained 07/27/2022. The facility was inspected, indoors and outdoors, for health and safety hazards.

Indoors: The school age program is exempt from requirements for indoor and outdoor space square footage, fencing, and toilet/sink ratios. No measurements were taken during the inspection. The programs will operate out of portable classrooms G, F, 1A, and Mult-purpose room only. Each classroom is equipped with appropriate furniture that is in good working condition. Storage for children's belongings are located inside the classrooms. Each classroom is equipped with a working carbon monoxide detector and smoke detector. Each classroom is also equipped with a fire alarm system installed and implemented. Medications with required documents and emergency supplies will be stored in classrooms high shelves, locked behind child safety locked cabinets. Emergency backpacks are also located in the classrooms that will be brought from indoors to outdoors.

All toxins and hazardous items will also be stored in locked cabinets, inaccessible to children. Isolation for a sick child will be in the classroom, separate from other enrolled children. Restrooms are located outside the classrooms, next to the multi-purpose area. Additional restrooms are located in the lower playground area also used for program that allows for individual privacy. LPA observed restrooms to be clean and in proper working condition. Program will use school district garbage cans and bins that will be disposed of daily by school district site's janitorial services.

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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2022
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: AFTERSCHOOL CARE ENRICHMENT (ACE) @ ARUNDEL
FACILITY NUMBER: 414004908
VISIT DATE: 08/09/2022
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Program will provide breakfast during morning program, lunch during early dismissal, and dry, afternoon snacks daily. Applicant and director are aware food is not to be stored near toxins and poisons. Water is accessible to enrolled children with accessible water fountains and refillable pitchers with disposable cups.

Outdoors: Program has exclusive access and use to lower playground. Entire outdoor area of the school is enclosed by a fence that is at least four feet tall. Separate after school program will also operate on elementary school site that is separate from ACE program. Applicant and director are aware children from separate after school program are not to co-mingle with children enrolled with ACE program.

LPA observed playground to be equipped with climbing structures appropriate for children's age group. Resilient padding is installed under climbing, play structures. Applicant and director are aware enrolled children walking to and using the lower playground will always be supervised and monitored.

Applicant and director are aware disaster drills are to be conducted at least once every six months and properly logged and maintained. All required licensing documents and posters are properly posted in classroom F, available for review.

Applicant and director were 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.

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

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

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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
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: AFTERSCHOOL CARE ENRICHMENT (ACE) @ ARUNDEL
FACILITY NUMBER: 414004908
VISIT DATE: 08/09/2022
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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.

After today's visit, LPA will approve for a license effective today's date, for requested capacity of 90 children.

Exit interview conducted and report was reviewed with applicant, Eve Daskalakis, and director, Victoria Ruiz.
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC809 (FAS) - (06/04)
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