010211875-1-14-2020-02-CC-BNEN-BKTV63-20200114150853

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010211875
Report Date: 01/14/2020
Date Signed: 01/14/2020 03:08:56 PM

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	KIDS IN MOTION		FACILITY NUMBER:	010211875
ADMINISTRATOR:	THOMPSON, TROY		FACILITY TYPE:	840
ADDRESS:	2955 CLAREMONT AVENUE		TELEPHONE:	(510) 549-9247
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94705
CAPACITY:	70	CENSUS: 16	DATE:	01/14/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Troy Thompson		TIME COMPLETED:	04:15 PM

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On 01/14/2020, Licensing Program Analyst (LPA) Brittany Newton met with Director Troy Thompson for an unannounced random inspection. There are 4 staff members including the director present with 16 children. A health and safety inspection was conducted inside and out.

The classroom and the outside yards were toured. The climbing structures are in good condition and have resilient material underneath them. Children use the three yards associated with this elementary school after the elementary school is closed for the day. Drinking water is available. Snacks are provided and prepared by a staff. LPA Newton seen preparation of organic pineapples, apples, and bananas for the snack today. There are sufficient toys and equipment for children in care. There are first aid supplies available for use. CPR and First Aid are current for the director and staff through 3/20. Sign-in/out sheets were reviewed for accuracy of children present and was found in compliance. LPA Newton reviewed children files which were found in compliance. 2 staff files reviewed were complete, one staff file was unavailable for review. Facility will send this staff's file to LPA Newton by 01/28/2020.
Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes 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

Facility is reminded that ALL assistants, volunteers, frequent visitors 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. Licensee was reminded of the responsibility as a mandated reporter. Two staff need to complete mandated reporter training, the website is mandatedreporterca.com (2 components: General Training and Child Care Providers) Facility will send completion certificates to LPA Newton by 01/28/2020.

A copy of the child care roster and personnel report was obtained.

No deficiencies observed at this visit. A Notice of Site visit was given and facility was reminded that it is required to be posted for 30 days. Exit interview conducted, appeal rights provided, and a copy of this report was left with Director Troy Thompson.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany Newton	TELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020

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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