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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005013
Report Date: 09/20/2023
Date Signed: 09/20/2023 10:59:04 AM

Document Has Been Signed on 09/20/2023 10:59 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:PENINSULA JEWISH COMMUNITY CENTERFACILITY NUMBER:
414005013
ADMINISTRATOR:FRANCIS, NICOLEFACILITY TYPE:
830
ADDRESS:800 FOSTER CITY BLVD.TELEPHONE:
(650) 212-7522
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY: 19TOTAL ENROLLED CHILDREN: 9CENSUS: 9DATE:
09/20/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Nicole FrancisTIME COMPLETED:
11:15 AM
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On August 20, 2023 at approximately 8:30am, Licensing Program Analyst (LPA’s) Maria Olguin-Leon, Man Tso and Catrina Quimbo conducted an unannounced case management inspection at Peninsula Jewish Community Center. Facility submitted an application on September 1, 2023 for an increase of capacity for infant program. LPA’s met with director, Nicole Francis, and explained the purpose of the inspection. Fire inspection approval was received in our office on September 14, 2023. Present during visit included 9 enrolled infants with 5 teaching staff.

Program is a licensed combination program for infant, preschool and school age children. The program is adding classroom #10 to their infant program and decreasing classroom from preschool capacity. Program is requesting to increase capacity for 19 infants to 29 infants. Director plans to use classroom #10 for infants ages 13 months to 24 months. Director was reminded that preschool children cannot co-mingle with the infant program.

Classroom #10, previously a preschool classroom, was measured today for the infant classroom. Classroom #10 was measured for 711 sq ft. . The total allowable capacity measured for Classrooms #10 measures for 711 sq ft. equaling 20 infants. Per fire inspection, classroom was approved for 10 infants only.

Classroom includes a bathroom with two working toilets and three sinks. Classroom also includes a separate sink with a drinking fountain that children will have access to. LPA's observed classroom to be equipped with a variety of toys and equipment that was in good working condition. Classroom is equipped with fire sprinklers, first aid kits and emergency backpacks. Per director, the smoke detector is a dual carbon monoxide detector that is integrated in school fire alarm system. LPA's observed detector in classroom ceiling. Cabinets and drawers in classroom were observed to have child safety locks installed. Electrical outlets were made inaccessible with child safety covers. Program will utilize cots for napping children that will be stored in the classroom.

Cont. page 2...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2023
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: PENINSULA JEWISH COMMUNITY CENTER
FACILITY NUMBER: 414005013
VISIT DATE: 09/20/2023
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Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Director is aware classroom #10 must be fully set up and cleared of storage prior to children's use.

LPA's will approve for the 29 infants once classroom #10 is fully set up. Director to send photos of classroom to LPA's once complete.

A copy of this report, and the “Notice of Site Visit” were given to the director. A “Notice of Site Visit” must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Director, Nicole Francis.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC809 (FAS) - (06/04)
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