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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400049
Report Date: 01/10/2025
Date Signed: 01/10/2025 11:18:19 AM

Document Has Been Signed on 01/10/2025 11:18 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:COUNTRY DAY LITTLE SCHOOLFACILITY NUMBER:
434400049
ADMINISTRATOR/
DIRECTOR:
PEGGY JANE TRIULZIFACILITY TYPE:
850
ADDRESS:3990 VENTURA COURTTELEPHONE:
(650) 507-5787
CITY:PALO ALTOSTATE: CAZIP CODE:
94306
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 12DATE:
01/10/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Amanda “Ananda” TriulziTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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On 01/10/2025 at 9:05am, Licensing Program Analyst (LPA) Jialing “Julianne” Zhu met with Director Amanda “Ananda” Triulzi for an unannounced annual inspection. Present during the inspection were director, three (3) fingerprint-cleared staff, and 12 children in care. The facility is within ratio and in compliance with capacity regulations today. Upon arrival, LPA provided director a copy of the Entrance Checklist (LIC 125). The facility was toured to conduct a Health and Safety Inspection. The facility’s current hours of operation are Monday - Friday from 8:30am - 5:00pm. The facility is located on a former elementary school owned by Palo Alto Community Child Care (PACCC) who leased former classrooms to day care providers. There are multiple licensed child care facilities on premises. The facility’s indoor and outdoor spaces are physically separated from the other facilities.

Classrooms: This facility is licensed with two (2) classrooms (Rooms 10 and 11), and both are currently in use. Classrooms were inspected for age-appropriate furnishings, equipment, and adequate storage for children’s belongings. LPA observed the cleanliness of floors and surfaces. The facility is equipped with telephone service, battery-powered smoke and carbon monoxide detectors, and fully charged 2A10BC fire extinguishers that are accessible throughout the facility. Per director, the alarms are serviced annually by the Palo Alto Fire Department. Fully stocked first-aid kits are available in the classrooms. LPA inspected the napping equipment and observed them to be stored in a healthful manner. Bedding is brought from home and returned home to be washed weekly. Drinking water is accessible by children in the classrooms. The isolation area for when a child is sick is the office.

Food Service Areas: The facility provides meals and AM/PM snacks to children in care. All center provided food items are properly labeled and stored separately from cleaning supplies. Food prep area is clean, adequately equipped, and free from hazardous materials. Snack menus are posted and were reviewed. Solid waste bins are equipped with tight fitting lids.

Page 1 of 3. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2025
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: COUNTRY DAY LITTLE SCHOOL
FACILITY NUMBER: 434400049
VISIT DATE: 01/10/2025
NARRATIVE
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Bathrooms: Facility has separate staff and child designated bathrooms. Toilets and faucets are in safe, sanitary, and operating condition. The children are able to reach the sinks, toilets, and supplies.

Outdoor Play Area: The outdoor play area is fully fenced. All equipment and surfaces are free from hazards. There is ample shade available. There are age-appropriate outdoor toys and materials for the children. there is a sandbox that is cleaned daily. Drinking water is accessible by children when outside. There are no pools or other bodies of water on premises.

Files and Record Keeping Review: LPA reviewed the facility roster and personnel report, and copies were obtained. All individuals subject to criminal record review have a clearance and/or exemption and have been associated to the facility. LPA reviewed four (4) staff files. Every classroom has a fully qualified teacher. At least one opening/closing staff member has a current Pediatric CPR/First-Aid Certification. Mandated Reporter Training certificates were reviewed and current. Director’s Mandated Reporter training certificate expires on 09/24/2026. LPA reviewed five (5) children’s files. Children’s files were complete. The center utilizes a paper sign-in/out system and is in compliance with sign-in/out procedures. Fire/disaster drills are performed at least once every six months. The last drill was a fire drill conducted on 09/18/2024. Per director, there are no firearms on the premises. All required documents are posted in a publicly accessible area.

Record Keeping and Reporting Requirements: Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Facility roster and personnel report must be properly maintained, and fire/disaster drills must be conducted at least every six (6) months and documented. Effective August 1, 2003 California Law requires Child Care Licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury Form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624, within seven (7) business days. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov.

Criminal Record Clearance: 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.

Page 2 of 3. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: COUNTRY DAY LITTLE SCHOOL
FACILITY NUMBER: 434400049
VISIT DATE: 01/10/2025
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Lead Testing: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA referred director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

MyChildCarePlan.org: Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Incidental Medical Services (IMS): This facility does provide Incidental Medical Services (IMS), but no enrolled children require IMS at this time. For IMS information see PIN 22-02-CCP. 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/resources/child-care-centers/.

CCLD Information and Updates: 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 platforms. 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.

No deficiencies cited during today's inspection. One (1) Advisory Note was issued.

Advisory Note: 1 of 4 staff files reviewed by LPA did not have a TB test completed within 1 year prior to employment.

A Notice of Site Visit was given and must remain posted for 30 days. Exit interview was conducted, report was reviewed, and Appeal Rights were provided to Director Amanda “Ananda” Triulzi.

Page 3 of 3. End of Report.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4