414005013-6-29-2023-05-CC-CQUO-CT9T6W-20230629142749

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414005013
Report Date: 06/29/2023
Date Signed: 06/29/2023 02:27:54 PM

Document Has Been Signed on 06/29/2023 02:27 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	PENINSULA JEWISH COMMUNITY CENTER		FACILITY NUMBER:	414005013
ADMINISTRATOR:	FRANCIS, NICOLE		FACILITY TYPE:	830
ADDRESS:	800 FOSTER CITY BLVD.		TELEPHONE:	(650) 212-7522
CITY:	FOSTER CITY	STATE: CA	ZIP CODE:	94404
CAPACITY: 19	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	06/29/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Nicole Francis, Lauren Ngoi, Kirsten Hove & Renee Keller		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On June 29, 2023 at approximately 8:30am, Licensing Program Analyst (LPA) Catrina Quimbo conducted a pre-licensing inspection at Peninsula Jewish Community Center. LPA met with applicants, Nicole Francis and Lauren Ngoi, and explained the purpose of the inspection. Also present during visit included consultant, Kirsten Hove, and operations manager, Renee Keller. Program is an already licensed combination program for preschool and school age children. The applicants are requesting for an infant program for 19 infant children (ages 3 months to 23 months). The facility is located at Peninsula Jewish Community Center. Main entrance to program will be through side gate located on South Road. The infant program will operate Monday through Friday 8:30am to 5:30pm, year round. Children will be signed in and out of facility with electronic signatures. Applicants plan to have electronic tables in the infant classrooms that children's families will utilize for their electronic signatures. The designated director will be Nicole Francis. The facility was inspected, indoors and outdoors, for health and safety hazards and measured to calculate capacity. Indoors: Program is dual licensed program. The infant program will utilize 2 classrooms (Classroom #1 and Classroom #2) that were previously used by preschool program. Classroom #1 (3 months to 12 months) was measured for 544.68 sq ft. allowing for a capacity of 15 children. Classroom #2 (13 months to 23 months) was measured for 591.18 sq ft. allowing for a capacity of 16 children. The total square footage equals 1,135.7 sq ft. allowing for a capacity of 32 infant children. LPA observed infant classrooms to be clean, equipped with a variety of toys and materials, that were age appropriate. Flooring in classroom includes both carpeting and hard floor that was observed to be clean and in good condition. LPA observed classrooms to have a diaper changing table that was within arm's reach to a sink. Sufficient storage space for children's personal belongings is located inside the classroom, that will be labeled with each child's individual names. (Continue Report on Page 2...)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PENINSULA JEWISH COMMUNITY CENTER	FACILITY NUMBER: 414005013
	VISIT DATE: 06/29/2023

NARRATIVE

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Both classrooms have a bathroom that includes 2 toilets and 2 sinks. Total are 4 toilets and 4 sinks accessible to children. The total allowable capacity for toilets is 60 children. The total allowable capacity for sinks is 60 children. LPA observed bathrooms to be in proper working condition. Garbage bins were observed to have tight fitting lids.

LPA observed the electrical outlets in classrooms to be made inaccessible with child safety covers. Poisons, cleaning supplies, or hazardous materials will be stored inaccessible to children, locked behind child safety locked cabinets and/or located in classroom's high shelves. LPA observed all cabinets and drawers in both classrooms to have child safety locks on them. Sharp edges of furniture were observed to have padding for additional safety.

Both classrooms are equipped with a fully charged fire extinguisher, fire sprinklers and fire alarm system. Per applicant/director, carbon monoxide detectors are integrated through smoke/fire alarm system. Classrooms have multiple emergency backpacks that includes first aid and emergency information and materials. One emergency backpack remains in the classroom while a separate emergency backpack is transported to and from the classroom to the outdoor area.

Program plans to provide napping infants with cribs and cots. Children are to provide their own sheets and blankets. Per applicants, sheets will be sent home weekly for laundering, or as needed. Classrooms also include a refrigerator and counter space for bottle/food prep. LPA discussed with applicant labeling infants' bottles and food requirements.

Designated isolation area will be located in facility office. LPA observed office to have a separate cot and bathroom for children in isolation. Facility's discipline policy will be natural consequences and communicating with families, identifying children's needs.

Infant program does not plan to provide a food service at this time. Families are to provide infants children's bottles, food and meals. Children are to provide their own, water containers that can be refilled at facility if needed. Water is available to children both indoors and outdoors with children's individual water bottles.

Medications with children’s individual names and required documentation will be stored both in the classroom and in the facility office. Medications that require refrigeration will be stored in a locked box in the classrooms' refrigerator. 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: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PENINSULA JEWISH COMMUNITY CENTER	FACILITY NUMBER: 414005013
	VISIT DATE: 06/29/2023

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Outdoor: The outdoor area is located directly outside the classrooms, passed the preschool yard. Applicants plan for staff to push infants to and from outdoor area on a stroller and/or walk infants. The outdoor area measures for 2,752.43 sq ft. allowing for a capacity for 36 children. Entire outdoor area is enclosed with an at least 4 ft. high fence. Applicants stated an additional fence may be installed in the infant day care area in the future. LPA reminded applicants to inform department of when fence will be installed.

Outdoor area was observed to be clean. Applicants plan to utilize mats for infants in outdoor area who may be crawling, walking. Portable umbrellas are utilized for shade when needed. Applicants plan to install a permanent tent in outdoor area for additional coverage.

LPA reminded applicants to conduct and document emergency disaster drills at least once every six months. Applicants are aware infant and preschool children cannot co-mingle at any time.

Applicants 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 discussed the safe sleep regulations with applicants 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 applicants 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 applicants the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PENINSULA JEWISH COMMUNITY CENTER	FACILITY NUMBER: 414005013
	VISIT DATE: 06/29/2023

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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.

Prior to recommended licensure, following must be complete:
-Updated fire clearance with updated capacity.
-Full review of resubmitted documents.
-Submission and approval of preschool decrease capacity application.

Exit interview conducted and report was reviewed with co-applicant, Lauren Ngoi.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

LIC809 (FAS) - (06/04)

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