010214758-9-22-2022-52-CC-MOTI-CJHSFC-20220922135008

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010214758
Report Date: 09/22/2022
Date Signed: 09/22/2022 01:50:17 PM

Document Has Been Signed on 09/22/2022 01:50 PM - It Cannot Be Edited

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:	BAY AREA CHILD CARE - GOMES		FACILITY NUMBER:	010214758
ADMINISTRATOR:	SIDDIGUI, SAYEEDA		FACILITY TYPE:	840
ADDRESS:	577 LEMOS LANE		TELEPHONE:	(510) 490-4222
CITY:	FREMONT	STATE: CA	ZIP CODE:	94539
CAPACITY:	57	CENSUS: 8	DATE:	09/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Sayeeda Siddigui		TIME COMPLETED:	02:10 PM

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On 09/22/2022, Licensing Program Analyst (LPA) Melanie Otsuji conducted an UNANNOUNCED REQUIRED 1-YEAR INSPECTION. LPA met with Director, Sayeeda Siddigui. Also present during today's visit was 2 additional staff members and 8 school aged children. On today's date, the facility is within ratio and capacity. The facility currently operates 7:00am - 6:00pm, Monday - Friday in 1 classroom. The facility was toured to conduct a Health and Safety inspection. Facility resides on the campus of Fremont Unified School Districts Gomes Elementary School.

Classrooms: The classroom was inspected for age-appropriate furnishings, equipment, & adequate storage for children’s belongings. LPA observed the cleanliness of floors & surfaces, the presence of a fully functional carbon monoxide detector, smoke detector/fire alarms, and a fully charged fire extinguisher that is accessible throughout the facility. Fire/Disaster Drills are conducted routinely with the last one occurring on 9/7/2022. The center is equipped with a fully stocked first-aid kit and available in the classroom. Food Service Areas: Facility has a food-prep area. No cleaners were found stored with food items. Facility has lunch provided by the school district. Facility provides AM/PM snacks. Bathrooms: Facility utilizes the Elementary School bathrooms. Children do not commingle with the elementary school children. Toilets and faucets are in safe and sanitary operating condition. The children are able to reach the sinks and toilets. Supplies are available to children. Outdoor Play Area: Facility utilizes the Elementary School playground/blacktop. There are no bodies of water, or free-standing water accessible to children. There are age appropriate toys and materials for the children. The playground outside have surfaces are free from hazards. Records: All individuals subject to criminal record review have a clearance and have been associated to the facility. LPA reviewed 10 children’s files and 4 staff files. LPA reviewed the facility roster must be sent to LPA no later than 10/6/2022. At least one opening/closing staff member has a current Pediatric CPR/First-Aid Certification. Mandated Reporter certificates were reviewed. The center is in compliance with sign in and out procedure. Per facility representative, there are no firearms on the premises. All required documents are posted in a publicly accessible area.

***Continued on LIC 809C***

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

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: BAY AREA CHILD CARE - GOMES	FACILITY NUMBER: 010214758
	VISIT DATE: 09/22/2022

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Health-Related Services: This facility plans to provide Incidental Medical Services. For IMS information see Evaluator Manual – Regulation Interpretations & Procedures for Child Care Centers sections 101173 & 101226. 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

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

No citations were found on today's date. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Sayeeda Siddigui and Michele Massrao.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

LIC809 (FAS) - (06/04)

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