430700018-9-2-2022-52-CC-RHAR-CHVRH4-20220902130144

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430700018
Report Date: 09/02/2022
Date Signed: 09/02/2022 01:01:59 PM

Document Has Been Signed on 09/02/2022 01:01 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	DOWNTOWN CHILDREN'S CTR		FACILITY NUMBER:	430700018
ADMINISTRATOR:	MELLISA STEPHENS		FACILITY TYPE:	850
ADDRESS:	555 WAVERLY		TELEPHONE:	(650) 321-9578
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94301
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 21	CENSUS: 18	DATE:	09/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Melissa Stephens / Michelle Yee-De La Cruz		TIME COMPLETED:	01:10 PM

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On September 2, 2022 at approximately 9:00am, Licensing Program Analyst (LPA) Haderer arrived unannounced for an annual inspection for compliance to Health and Safety. The new CARE tool was used for the inspection. Present for the inspection was the site director Melissa Stephens and Michelle Yee-De La Cruz, 3 teaching staff (fingerprint cleared and associated with facility) and 18 children in care (toddlers and preschoolers between 2 and 5 years old). The facility is in ratio today.

The facility has a toddler option and operates on property of the All Saints Episcopal Church in a single building containing two classrooms (rooms 2 and 3) and a kitchenette (room 1) on the ground floor and an office upstairs. There is a child gate to prevent child access to the stairs.

The facility has a fully enclosed playground areas with ample shade and a small sandbox areas and permanent play structures. Storage sheds are present and do not contain anything hazardous to children. The playground area is in safe condition and free from sharp, loose or pointed parts and the areas around or under high climbing equipment has appropriate cushioned material that absorbs a fall. Water is available for children inside the classrooms and in the playground area. Children are supervised at all times when playing outside. Heating and ventilation in the facility is acceptable.

Sharp objects (knives, scissors) are kept in drawers of the kitchenette out of reach of children. All disinfectants and cleaning solutions are stored out of the reach of children.

The facility is clean and well organized with ample age appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. There are no bodies of water accessible to children in care. The facility provides snacks and catered lunch for the children. Milk for the children was 2%, however, for children over 2 years of age, only 1% or non-fat may be served. LPA found some expired dry goods/snack food for the children. A Technical Violation (not a deficiency) was issued.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022

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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: DOWNTOWN CHILDREN'S CTR	FACILITY NUMBER: 430700018
	VISIT DATE: 09/02/2022

NARRATIVE

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The facility has three fully charged 3A40BC fire extinguishers, last serviced 8/9/2022. Combined carbon monoxide and smoke detectors were available in each classroom, tested and functioning. Fire drills are conducted at least once every six months, the last drill was conducted 8/23/2022. First aid kits and supplies are available and kept in the kitchenette area and smaller supplies in the classrooms. Signed parent permission to apply creams etc. for small children were present.

Throughout the facility there are trash cans with tight fitting covers for the disposal of solid waste. All required posters are present, License; Parents Rights; Personal Rights; Emergency Disaster Plan; Seatbelt Laws poster. Children’s bathroom has enough towels and soap supplies. The staff have separate adult bathrooms. There are sleeping cots with the crib sheets for napping children. The sheets are laundered once each week.

Staff files were reviewed, all records were complete and in good order. Staff are all up to date with CPR/1^st Aid certificates (at least one staff opener/closer and through the day has CPR training). All had non-expired Mandated Reporter certificates.

Children's records were reviewed: LPA requested and reviewed facility roster, a photo copy was made for the office file. One of ten children’s file checked did not contain the Physician’s Report, see LIC809D for deficiency. Overall, all children’s files were complete and in good order.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022

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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: DOWNTOWN CHILDREN'S CTR	FACILITY NUMBER: 430700018
	VISIT DATE: 09/02/2022

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Site Director was reminded that all adults 18 and over, 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

There was 1 deficiency issued today, see LIC809D. This report will remain on file for 3 years.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Site Director Michelle Yee-De La Cruz.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/02/2022 01:01 PM - It Cannot Be Edited

Created By: Russell Haderer On 09/02/2022 at 12:32 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: DOWNTOWN CHILDREN'S CTR	FACILITY NUMBER: 430700018
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/02/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Request Denied

Type B

Section Cited

CCR

101220(a)

Child's Medical Assessments

(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that one of the ten children's files checked did not contain the required Physicians Report which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/30/2022
	Plan of Correction
1 2 3 4	Facility to obtain a Physician's Report for the child. Center staff will inventory all current children's files to ensure they contain all licensing required documents, and will ensure completeness going forward as well.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Chandra Charles

LICENSING EVALUATOR NAME:

Russell Haderer

LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022

LIC809 (FAS) - (06/04)

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