Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002261
Report Date: 06/17/2016
Date Signed 06/17/2016 12:05:03 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:PEEKADOODLE ACADEMY PRESCHOOLFACILITY NUMBER:
384002261
ADMINISTRATOR:KAYLA LEE, PRES./DIR.FACILITY TYPE:
850
ADDRESS:900 NORTH POINT ST., STE. F100TELEPHONE:
(415) 440-7335
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94109
CAPACITY:60CENSUS: 20DATE:
06/17/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Kayla LeeTIME COMPLETED:
11:45 AM
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
2, LPA Ng conducted an unannounced random annual visit. LPA met with Kayla Lee, Site Director during the visit. Facility is a preschool program center. There are 19 children 4 staff members. The school operates at a lower capacity during the summer session, in this visit rooms 1 and 7 were being utilized. Director states that she has no knowledge of any guns or weapons in the facility. In the classroom furniture and equipment are age appropriate and in good repair. There is adequate heating, lighting and ventilation. A carbon monoxide detector was observed, tested and working. Drinking water is readily available via water pitcher and paper cups, there is sufficient space for the group size being served. There are separate toilet and sinks available for staff & children. There are sufficient mats for each child bedding accessories are cleaned once a week . Proper staffing ratios are maintained. The bathroom were inspected the toilets flushed and the faucets are working, sinks are reachable by children by the use of step stools, toilet paper, soap and towels are available and the bathrooms are clean. Hot water was tested at 85 degrees F. In regards to food service, the school provides lunch, and a morning and afternoon snack to the children. The food is prepared on site. There is a food prep kitchen area the, the food was inspected for freshness and all items were in compliance, the refrigerator had a reading of 32 degrees. The menu is posted. Health related services was discussed with the director she states medications will not be dispensed except those items that are used for emergencies such as epi-pens, benydrl, nebulizers, etc.) parents will provide a note if there is such a need. director states that medication will be stored in Lock boxes at the front desk and at the cafe refrigerator, facility will provide a updated medication policy to the LPA when completed. Children are greeted and checked for illness before entry into the facility. First aid supplies, a thermometer and emergency items are available. Isolation is provided in the office with the use of the Plaza bathroom which is located on the 3rd level, if needed. Records of staff were reviewed for qualifications of staff and children's records were reviewed for emergency and identification forms. Facility has posted the required forms (i.e. License, menus, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan). Staff persons are current with First Aid/CPR certification 08/2017. Site Director states Fire and Earthquake drills are done each month, the last one conducted was 05/04/16. CONTINUED>>>
SUPERVISOR'S NAME: Suzanne Roman-ClarkTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Tony NgTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2016
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 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: PEEKADOODLE ACADEMY PRESCHOOL
FACILITY NUMBER: 384002261
VISIT DATE: 06/17/2016
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
26
27
28
29
30
31
32
Regarding discipline the director states that the policy is positive reinforcement, preventative discipline and redirection. The facility has an outdoor space there are ample toys and activities for children. The outdoor area has a play structure, the structure was in good condition. The flooring material is of a soft rubber surface. The facility also enhances its outdoor space with 2 indoor gross motor spaces. The small gross motor space area was observed to be in good condition and the floor is padded. This facility also has a larger gross motor space which is scheduled use, there were no deficiencies noted in this area. The children using this space are not co-mingled. LPA also went over all new regulations with the Licensee ( IMS (ADA.gov), immunization, Toddlers, Civil penalties, smoking prohibition, Pesticides (DPR.ca.gov), Carbon monoxide detectors and Childhood Nutrition training. LPA observed Site Director posting the Notice of Site Visit. The report was reviewed with the director and no deficiencies were observed in this visit.
IMS:
IMS was discussed with the director this facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative records. File reviews of children and staff for IMS was conducted. The director was advised that information can be found on the website at ccld.ca.gov.

What is IMS?
  • Blood Glucose monitoring
  • Administration of: inhaled medication, Epi-pen and Epi pen Jr. or other epinephrine auto injectors, glucagon, gastronomy tube feeding and care, insulin injections, anti-seizure medications.
  • Carrying out medical orders when the child's physician has determined that a layperson can be trained and safely carry out the orders.
Prescription and non-prescription medications not associated with an IMS do not require an IMS Plan.

PESTICIDES:
Pesticide regulations were discussed with the director, In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The director was advised that a free one hour online course is available on the Department of Presticide Regulation's Web site: www.cdpr.ca.gov/schoolipm/training. If the director had questions she can email ccipmlist@cdpr.ca.gov. Director was also advised that bleach is considered to be a pesticide under the law.
SUPERVISOR'S NAME: Suzanne Roman-ClarkTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Tony NgTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2016
LIC809 (FAS) - (06/04)
Page: 2 of 2