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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415072
Report Date: 02/13/2023
Date Signed: 02/13/2023 11:19:05 AM

Document Has Been Signed on 02/13/2023 11:19 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KIDS CHOICE AFTER SCHOOL CAREFACILITY NUMBER:
434415072
ADMINISTRATOR:LORENE SCATENAFACILITY TYPE:
840
ADDRESS:1711 STANFORD AVENUETELEPHONE:
(650) 656-8170
CITY:STANFORDSTATE: CAZIP CODE:
94305
CAPACITY: 98TOTAL ENROLLED CHILDREN: 98CENSUS: 0DATE:
02/13/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:46 AM
MET WITH:Lorene ScatenaTIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA) Melanie Otsuji conducted an announced Case Management - Licensee Initiated inspection on today's date, 2/13/2023. LPA was met by Director, Lorene Scatena. Facility is currently closed so no children are present during today's visit. The center has submitted an application for a CAPACITY DECREASE to the SCHOOL AGE license. SCHOOL AGE COMPONENT is currently requesting to decrease from 98 school age children to 84 school age children. The school age program is located in two portables on Nixon Elementary School campus which is part of the Palo Alto Unified School District. Portables are located on the side of Nixon Elementary School nearest the bottom parking lot located on Stanford Avenue. Facility days and hours of operation are Monday, Tuesday, Thurs, Friday 2:00PM - 6:00PM, Wednesday 1:00PM - 6:00PM. During school breaks and summer break facility is open Monday - Friday 8:00AM - 6:00PM. A health and safety inspection was conducted inside and outside. This facility is exempt from square footage and bathroom regulations. Therefore no measurements were taken.

INDOORS: EXEMPT
OUTDOORS: EXEMPT

Kids Choice After School Care will have 2 approved portables. Facility utilizes Nixon Elementary playground, grassy area and blacktop and does not commingle with the school children. Facility has a sign in/out sheet that allows ample space for full legal signature and records time and date. Per Director, all Opening and Closing staff have current Pediatric CPR/First Aid. Playground equipment is in good condition.
The rooms are equipped with varied age appropriate materials and equipment. Facility will provide AM/PM snacks with lunch from home. Drinking water is provided inside and out via way of water bottles from home. Facility has a functioning smoke detector and carbon monoxide detector. Facility also has a fire extinguisher which is easily accessible.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2023
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDS CHOICE AFTER SCHOOL CARE
FACILITY NUMBER: 434415072
VISIT DATE: 02/13/2023
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This facility provides Incidental Medical Services - IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

All licensing required documents are posted. Zero Tolerance policies were explained. Notice of Site Visit form was provided and posted. The center was found to be clean, safe, sanitary and in good repair. There were no deficiencies cited during this visit.

A license for 84 school aged children operating out of 2 portables will be issued effective today's date, 2/13/2023.

An exit interview was conducted was conducted with Director, Lorene Scatena.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2