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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004949
Report Date: 01/26/2023
Date Signed: 01/26/2023 09:56:04 AM

Document Has Been Signed on 01/26/2023 09:56 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PENINSULA CHILD CARE, 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) 827-8400
CITY:SO. SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 36TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
01/26/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Eric ClaybonTIME COMPLETED:
10:15 AM
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On January 26, 2023 at approximately 8:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted a follow up pre-licensing inspection. LPA met with applicant, Eric Claybon, and explained the purpose of the visit.

LPA conducted an initial pre-licensing inspection December 21, 2022. The program will operate on the Adult Education Site in Classrooms #45 and #46 only. Neighboring building includes Baden High School Campus. The program will be called SSFUSD Southwood Child Development Center.

Based on LPA's visit conducted 12/21/2022, following had to 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.

During LPA's visit conducted on this date, no measurements were taken today. LPA inspected day care areas, inside and out, for corrections needed. LPA observed both classrooms that will be utilized for preschool program to be equipped with new, fully stocked first aid kits. Both classrooms are also equipped with a fire alarm system, carbon monoxide detectors and fully charged fire extinguishers.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SSFUSD BADEN CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004949
VISIT DATE: 01/26/2023
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Cribs that were kept in Classroom #45 have been removed. Program plans to utilize cots for napping children. Both classrooms are now equipped with sufficient, age appropriate furniture, toys and materials that were good working condition. Bathroom that children will utilize is located in Classroom #46 with 2 toilets. LPA observed diaper changing table to be within arm's reach of sink in classroom. Applicant is aware diaper changing table must always be within arm's reach of sink.

LPA observed both classrooms to have cleared out and remove materials in classrooms' cabinets and shelves. Required licensing documentation are properly posted and available for review in both classrooms.

LPA observed outdoor area to have appropriately covered pot holes. Play structures in outdoor area have resilient padding of wood chips underneath. Installation of additional stairs on play structure in outdoor area has not yet been complete. Applicant has made area with play structure that is missing stairs inaccessible to children with caution tape. Applicant plans to include additional wood chips in area as well.

Applicant understands staff are to always monitor and supervise children when using play structure in outdoor area until installation of stairs has been completed. Applicant will send proof of installation to LPA at a later date.

Per applicant, all staff will complete Mandated Reporter (AB1207) training through department. During today's visit, applicant provided LPA copy of director's registration for CPR certification.

Prior to licensure, following must be completed:
-Updated fire clearance with updated capacity.
-CPR certification for director on site (scheduled for 2/7/2023).
-Livescan (fingerprint clearance) completion for applicant and/or director.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC809 (FAS) - (06/04)
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