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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010212832
Report Date: 11/13/2019
Date Signed: 11/13/2019 03:31:21 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:KIDS CARE PLUS - STANTONFACILITY NUMBER:
010212832
ADMINISTRATOR:LUDKE, DENISEFACILITY TYPE:
840
ADDRESS:2644 SOMERSET AVE. + PORTABLE.TELEPHONE:
(510) 733-0775
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY:85CENSUS: 42DATE:
11/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Annaleza Roque TIME COMPLETED:
03:45 PM
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On 11/13/19, LPA Briana Plumboy and Junell Chen met with Executive Director Annaleza Roque for an unannounced random inspection. Present for the inspection was 42 school age children and 4 staff. The center and playground were toured to conduct a Health and Safety inspection. The center is located inside of a portable on the far back end of Stanton Elementary School.

The center is safe, clean and in good repair. There is adequate storage for children's belongings. There is adequate furniture, games, and activities which are age appropriate and in good condition. The heating and lighting is adequate. There is drinking water readily available to children. There is a combined bathroom for boys and girls. All toilets flush properly, and there is running water, soap, and paper towels available for children to wash and dry their hands. There is a separate bathroom for staff. There are no bodies of water, or free standing water accessible to children during today's inspection. Per executive director, there are no firearms on the premises of the child care center. The food preparation area is clean, free from hazards and adequately equipped. The center serves children in care a snack when they get out of school, and an evening snack before the program closes. There is a menu posted, and there are no cleaning supplies stored with food. The center provides snack. The playground has age appropriate equipment. The play structure is designed for children ages 5 to 12 years old. All required documents are posted for public review. The center is in compliance with the sign in and out procedure. Disaster drills are being conducted at least once every 6 months, and the log indicates the last one done was on 10/24/19. The center is equipped with a fully stocked first aid Kit, working telephone, carbon monoxide detector, fire alarm and a 2A10BC fire extinguishers. The fire and carbon monoxide detector is connected to ADT Security per Executive Director.

The center roster was reviewed, and a copy was obtained. A review of 2 staff files was conducted. Staff have been fingerprint cleared and associated to this center. Staff have provided proof of immunization against pertussis and measles, and provided a note declining the influenza immunization. All opening/closing staff members have current CPR/First Aid certificate. Staff have completed the mandated reporter training.
See 809-C for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019
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: KIDS CARE PLUS - STANTON
FACILITY NUMBER: 010212832
VISIT DATE: 11/13/2019
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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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

The licensee is reminded any structural changes to the center/facility must be reported to Community Care Licensing. Licensee is reminded that ALL Staff must be fingerprint cleared 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.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019
LIC809 (FAS) - (06/04)
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