434410805-8-18-2021-52-CC-EWOS-C5ZQPM-20210818122057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410805
Report Date: 08/18/2021
Date Signed: 08/18/2021 12:21:07 PM

Document Has Been Signed on 08/18/2021 12:21 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:	T'ENNA PRESCHOOL AT THE OSHMAN FAMILY JCC		FACILITY NUMBER:	434410805
ADMINISTRATOR:	MYKENZIE BUSSER		FACILITY TYPE:	850
ADDRESS:	3921 FABIAN WAY		TELEPHONE:	(650) 223-8788
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94303
CAPACITY: 250	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	08/18/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Mykenzie Busser		TIME COMPLETED:	12:45 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 August 18, 2021, at 9:15 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced Annual Required Inspection and met with Director, Mykenzie Busser. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Director. There were no children present during this inspection and forty-two (42) additional staff members present. The playground and facility were toured inside and out for a health and safety inspection. The hours of operation are 9 AM-4 PM, Monday -Friday CLASSROOMS: The fourteen (14) classrooms were inspected. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The center is equipped with a working telephone, carbon monoxide detector, pull down fire alarm, and sprinkler system in every classroom. Each room has fully charged 3A40BC fire extinguishers and all solid waste storage containers have tight fitting covers on, and appear to be in good repair. ISOLATION: The isolation area for sick children is outside the office next to the entrance gate. BATHROOMS AND TOILETING AREAS: There are separate bathrooms for staff and children. Toilets and faucets are in safe and sanitary operating condition. The children are able to reach the sinks and toilets. Supplies are available to the children. Changing tables are next to the faucets in the bathroom. See 809-C

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

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: T'ENNA PRESCHOOL AT THE OSHMAN FAMILY JCC	FACILITY NUMBER: 434410805
	VISIT DATE: 08/18/2021

NARRATIVE

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FOOD SERVICE AREAS: The menus are posted at least one week in advance, available for review and dated. LPA observed the kitchen/food preparation and storage areas to be clean and free of evidence of rodents. Most classrooms have refrigerators and stoves.

OUTDOOR PLAY AREAS: There are no bodies of water, or free standing water accessible to children. There are age appropriate toys and materials for the children. The outdoor space for toddlers are physically separate from preschoolers. There’s a shaded rest area for children, multiple gardens, and a sand box/ beach area for play. The playground is fenced and all equipment and surfaces are safe and free from hazards. There are play structures for climbing that are anchored with cushioning underneath to absorb falls.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. No children's files were reviewed during today's inspection, but five (5) staff files were reviewed around 11:00 AM. All staff files have required health screening, employee rights, and mandated reporter training. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed and certificates were reviewed. Director's CPR and First Aid certificate is current and expires on 08/22/22. The center is in compliance with the sign in and out procedure.

Disaster drills are being conducted at least once every 6 months and the log indicates the last one conducted was on 05/13/2021. Per director, there are no firearms stored on the premises. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: The facility is not providing IMS, and no medication is being kept on-site at this time. The center is equipped with fully stocked first aid kits that are available in the classrooms.

See 809-C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

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: T'ENNA PRESCHOOL AT THE OSHMAN FAMILY JCC	FACILITY NUMBER: 434410805
	VISIT DATE: 08/18/2021

NARRATIVE

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California Law requires Family Child Cares/Child Care Centers 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 by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

Director is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Director was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

Incidental Medical Services (IMS) policy was discussed. Per director, no IMS is being provided at this time. The director was reminded that when any changes to the IMS plan is made, an updated Plan for Providing 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.” Licensee was reminded to visit our website at www.ccld.ca.gov to get quarterly updates on new laws and regulations.

No deficiency cited during today’s visit. A Notice of Site visit was posted at time of inspection and must remain posted for 30 days. Exit interview conducted with the Director. A copy of the report was provided

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

LIC809 (FAS) - (06/04)

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