010214465-1-14-2020-52-CC-MOTI-BKTV24-20200114150230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010214465
Report Date: 01/14/2020
Date Signed: 01/14/2020 03:02:35 PM

COMPREHENSIVE INSPECTION

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:	FUSD - DURHAM STATE PRESCHOOL		FACILITY NUMBER:	010214465
ADMINISTRATOR:	VERA, MARIA		FACILITY TYPE:	850
ADDRESS:	40292 LESLIE STREET		TELEPHONE:	(510) 656-6360
CITY:	FREMONT	STATE: CA	ZIP CODE:	94538
CAPACITY:	24	CENSUS: 16	DATE:	01/14/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:38 PM
MET WITH:	Fanny Luo		TIME COMPLETED:	03:22 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	Licensing Program Analyst (LPA) Melanie Otsuji arrived to the facility unannounced to conduct a Required 1 Year inspection. LPA was met Head Teacher Fanny Luo. Present during today's visit were 2 staff members, 2 parent volunteers and 16 preschool aged children. The center currently operates an AM/PM Session. LPA toured the facility and play yard for a health and safety inspection. The preschool component utilizes classroom 4. A review of staff record and children records is being conducted today, 1/14/2020. The teacher/child ratio was being met. The classroom and play yard are age appropriate and in good repair. Bathrooms are clean and in working order. The staff have a separate bathroom. The sign in and out logs were reviewed and accurate. All posting requirements are being met. Outdoor play area was free of hazards and provided a shaded area for the children and access to drinking water. There is a working telephone and working carbon monoxide at the facility. Opening and closing staff have current CPR and first aid training. LPA observed there are tight fitting lids on trash cans located inside the center. The center documents and conducts fire/disaster drills with the last one documented on December 2019. 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 California Law requires Child Care Centers to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
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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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: FUSD - DURHAM STATE PRESCHOOL	FACILITY NUMBER: 010214465
	VISIT DATE: 01/14/2020

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Licensee is reminded that ALL assistants, volunteers, and staff, 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.

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

Director 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 Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
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

LIC809 (FAS) - (06/04)

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