Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 210111538
Report Date: 03/07/2018
Date Signed 03/07/2018 03:35:39 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:C.A.M.-NOVATO CHILDREN'S CENTER (SA)FACILITY NUMBER:
210111538
ADMINISTRATOR:JENNIFER CARLFACILITY TYPE:
840
ADDRESS:5520 NAVE DRIVETELEPHONE:
(415) 883-4385
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY:44CENSUS: 16DATE:
03/07/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Site Supervisor - Sonia VelasquezTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Manlutac performed an unannounced random/annual inspection at the facility at issue. LPA met with site supervisor Sonia Velasquez, purpose of the visit was explained. Present during the inspection were 16 school aged children, two teaching staff, and one music teacher. The facility was operating within ratio and within licensed capacity on this day. LPA inspected inside and outside of the facility for health and safety hazards.

LPA did not observe any firearms, weapons, or bodies of water on the premises. Chemicals and cleaning supplies are locked away underneath a sink inside the classroom. All play areas are physically separate from the preschool program that is on the same campus. Bathroom and kitchen surfaces appear clean and sanitary. The classroom is clean and orderly with a sufficient amount of learning materials and furniture in well repair. Trash receptacles have tight fitting lids and are in well repair. The facility has a carbon monoxide detector installed inside of the classroom. The outdoor play area is free from hazards.

Files were reviewed for required licensing documents. Children have their own separate files, personnel have documentation of current first aid/CPR certification, and teachers have appropriate ECE units. Personnel have complete immunization records and tuberculosis test results.

No deficiencies were cited on this day.

A copy of this report was reviewed and left with Sonia, along with a notice of site visit which is to be posted for 30 days.
SUPERVISOR'S NAME: Suzanne Roman-ClarkTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Lorenzo ManlutacTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2018
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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