010211857-2-16-2021-52-CC-MOTI-BYAQG7-20210216110904

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010211857
Report Date: 02/11/2021
Date Signed: 02/16/2021 11:11:12 AM

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:	EXTENDED DAY CHILD CARE - WALNUT GROVE		FACILITY NUMBER:	010211857
ADMINISTRATOR:	NATALIE GLYNN		FACILITY TYPE:	840
ADDRESS:	5199 BLACK AVENUE		TELEPHONE:	(925) 846-5519
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94566
CAPACITY:	120	CENSUS: 16	DATE:	02/11/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Vanessa Sinclair/Natalie Glynn		TIME COMPLETED:	01:27 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	DUE TO THE COVID-19 SHELTER IN PLACE ORDER BY THE GOVERNOR OF CALIFORNIA, THIS CASE MANAGEMENT INSPECTION WAS DONE VIA TELE-VISIT THROUGH FACETIME. A Case Management Visit was conducted on this date 2/11/2021 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA conducted televisit with Executive Director, Vanessa Sinclair and Site Director Natalie Glynn. An application was submitted for the Addition of Room. The center has requested to add the Multi-Purpose Room. The school age program is located on Walnut Grove Elementary School campus. The program is utilizing two portables and Room 401 on school grounds as well as the Multi-Purpose Room. Hours of operation are from 7:00AM to 6:00PM, Monday through Friday. Present today were 5 staff members and 16 school aged children. A health and safety inspection was conducted inside and outside. INDOORS: EXEMPT OUTDOORS: EXEMPT Facility utilizes Walnut Grove Elementary School's grassy area and blacktop. Drinking water is available inside and outside by way of water fountains and bottles brought from home. Menus are posted. A sample of the sign in and out logs were reviewed. Facility has a functioning carbon monoxide detector. The center has obtained an approved fire safety inspection from the Livermore-Pleasanton Fire Department on 12/16/2020. All licensing required documents are posted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021

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: EXTENDED DAY CHILD CARE - WALNUT GROVE	FACILITY NUMBER: 010211857
	VISIT DATE: 02/11/2021

NARRATIVE

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Per Director, all staff have current Pediatric CPR/First Aid. Blacktop and grassy area is in good condition. Drinking water is available inside and outside. This facility plans to provide Individual Medical Services – IMS. An updated Plan of Operation that includes IMS must be submitted to the Department when any changes are made. 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.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and the director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

Zero Tolerance policies were explained.
The center was found to be clean, safe, sanitary and in good repair.

There are no deficiencies cited during this televisit. Approval of the Multi-Purpose Room is approved as of today's date 2/11/2021.

An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021

LIC809 (FAS) - (06/04)

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