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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004949
Report Date: 12/21/2022
Date Signed: 12/21/2022 12:51:21 PM

Document Has Been Signed on 12/21/2022 12:51 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:SSFUSD BADEN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
414004949
ADMINISTRATOR:SULIMAN, HAGARFACILITY TYPE:
850
ADDRESS:825 SOUTHWOOD DRIVETELEPHONE:
(650) 827-8412
CITY:SO. SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 36TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/21/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Eric ClaybonTIME COMPLETED:
01:00 PM
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On December 21, 2022 at approximately 8:30am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an announced, pre-licensing inspection. LPA met with applicant, Eric Claybon, and explained the purpose of the inspection. The applicant is requesting for a capacity of 36 preschool children (2.6 years to 5 years old).

The facility will operate Monday through Friday from 8:00am to 4:00pm. The program will operate on the Adult Education Site in Classrooms #45 and #46 only. Neighboring building includes Baden High School Campus. Designated director on site will be Hager Suliman.

Children will be signed in and out of the facility with children's authorized parents' signatures. Applicant is aware in/out records must be made readily available for review during inspection. The facility was inspected indoors and outdoors for health and safety hazards and measured to calculate capacity.

Indoors: Program will operate in Classrooms #45 and #46 only. Entrance to classrooms are located on parking lot side out of Classroom #45.

Classroom #46 will be for children ages 3 years to 5 years old. Classroom #46 was measured for 838.25 sq ft. allowing for a capacity of 23 children. Classroom #45 will be for children ages 2.6 years to 3 years old. Classroom #45 was measured for 718.52 sq.ft. allowing for a capacity of 20 children. Total allowable capacity indoors was calculated for 1,556.7 sq ft. allowing for an overall capacity of 44 children.

Both classrooms were observed to be clean, equipped with a fully charged fire extinguisher, and a working carbon monoxide detector. Overall facility maintains a fire alarm system. Furnishings, toys and equipment were observed to be age appropriate, safe and in good working condition. Sufficient storage space is located inside each classroom. Applicant plans to utilize mats and/or cots for napping children. Children's authorized representatives will provide sheets that will be sent home weekly for laundering.
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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2022
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 4
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: SSFUSD BADEN CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004949
VISIT DATE: 12/21/2022
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Both classrooms are adequately ventilated and free of insects and bugs. Cleaning products will be stored in both classrooms' high cabinets and shelves.

Classroom#45 includes a separate observation area that will be used by adults only. Classroom#45 is equipped with one sink that children will have access to. Classroom#46 is also equipped with a sink that will be made available to children after bathroom use. The bathroom is located in Classroom#46 with two toilets. All sinks accessible to children do not provide water that is warmer than 120 degrees Fahrenheit. Total allowable capacity for sinks and toilets is 30 children.

Program will provide a food service that will include breakfast, morning snack and afternoon snack. Per applicant, school district food service is available for lunch services. Facility will require children to provide their own individually, labeled water containers that will be refilled at facility through accessible water fountains.

LPA reminded applicant to conduct and document emergency disaster drills at least one every six months. Required licensing documentation will be posted near main entrance in Classroom#45.

Medications with children's individual names and required documentation will be stored in a locked box, located in classroom's high cabinets and shelves. Medications that require refrigeration will be stored in observation area in Classroom#45.

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: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: SSFUSD BADEN CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004949
VISIT DATE: 12/21/2022
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Outdoor: The outdoor area includes a playground that program has exclusive use over. The preschool outdoor area measures for 6,309.87 sq ft. allowing for a capacity of 84 children. Outdoor area is enclosed with at least 4 ft. high fence. LPA observed outdoor area to be clean with appropriate outdoor materials. Adequate shade is provided by trees and adjacent buildings in surrounding area. Outdoor area includes play structures that have resilient padding underneath. Water is made available with accessible drinking fountains located outdoors.

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.

LPA discussed the safe sleep regulations with applicant 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 applicant 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.

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

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: SSFUSD BADEN CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004949
VISIT DATE: 12/21/2022
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Based on LPA's measurements from today's inspection, maximum capacity facility can be licensed for is 30 children, based on toilet to sink ratio.

From applicant during inspection, LPA received updated LIC200A.

Prior to recommended licensure for 30 children, following must be completed:
-Updated fire clearance with updated capacity request.
-CPR certification for director on site.
-Addition of fully stocked first aid kit.
-Posting of licensing documentation.
-Covering of pot holes in outdoor area.
-Installation of additional stairs on play structure in outdoor area.
-Removing of cribs in Classroom #45.
-Clearing out cabinets and shelves in both classrooms.
-Setting up appropriate furniture in both classrooms.
-Management approval.

Follow up visit will be conducted by LPA at a later date.

Exit interview conducted and report was reviewed with the applicant, Eric Claybon.
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4