010211960-7-22-2020-52-CC-MOTI-BRRS5F-20200722133417

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010211960
Report Date: 07/08/2020
Date Signed: 07/22/2020 01:34:33 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	EXTENDED DAY CHILD CARE - MURRAY SCHOOL		FACILITY NUMBER:	010211960
ADMINISTRATOR:	RONNINGEN, SAMANTHA		FACILITY TYPE:	840
ADDRESS:	8435 DAVONA DRIVE		TELEPHONE:	(925) 829-4043
CITY:	DUBLIN	STATE: CA	ZIP CODE:	94568
CAPACITY:	70	CENSUS: 31	DATE:	07/08/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Vanessa Sinclair		TIME COMPLETED:	01:35 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 7/8/2020 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA conducted televisit with Executive Director, Vanessa Sinclair and Site Director Samantha Ronningen. An application was submitted for Change of Capacity and Addition of Room. The center has requested to increase from 70 to 145 and adding the Multi-Purpose Room. The school age program is located on Murray Elementary School's campus. The program is utilizing a portable 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 10 staff members and 31 school aged children. A health and safety inspection was conducted inside and outside. INDOORS: EXEMPT OUTDOORS: EXEMPT Facility utilizes Murray Elementary School's playground 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 Dublin Fire Prevention Services on 6/24/2020. All licensing required documents are posted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2020

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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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 - MURRAY SCHOOL	FACILITY NUMBER: 010211960
	VISIT DATE: 07/08/2020

NARRATIVE

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Per Director, all staff have current Pediatric CPR/First Aid which expires March 2022. Playground equipment 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. A license for 145 school age children and approval of the use of the Multipurpose Room, will be issued effective today, 7/8/2020.

An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2020

LIC809 (FAS) - (06/04)

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