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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010214801
Report Date: 10/19/2022
Date Signed: 10/19/2022 11:16:07 AM


Document Has Been Signed on 10/19/2022 11:16 AM - 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:EXTENDED DAY CHILD CARE - FREDERIKSENFACILITY NUMBER:
010214801
ADMINISTRATOR:OCHOA, ROSAMARIAFACILITY TYPE:
840
ADDRESS:7243 TAMARACK DRIVETELEPHONE:
(925) 833-0127
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:180CENSUS: 0DATE:
10/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Director, Rosamaria OchoaTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Jyoti Saini met with Director Rosamaria Ochoa for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the director. There were no children present during the inspection. The program consists of two sessions: 7:00 am to 8:15 am and 12:10pm to 6:00pm Monday - Friday in room EDCC #1 (AKA Minnows, ages K-1st grade) and room # EDCC 2 ( AKA Shark, ages 2nd grade to 5th garde) on the Frederiksen Elementary School campus. The facility was inspected indoor and outdoor today for health and safety hazards and the following was observed;

There are no bodies of water, firearms, or weapons on the premises. The center is in good condition with proper temperature and ventilation and is free of any hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. The children and staff have a separate bathroom. The bathrooms appear to be safe, sanitary, and free of any hazardous items. There is drinking water readily available through water fountain and water bottles brought from home.Facility provides AM/PM snacks. There is a menu posted for the entire month. The classroom has appropriate postings. The last Emergency Drill was conducted on 10/07/2022 at 01:15pm and is properly logged. Outdoor play area was free of hazards and provided a shaded area for the children. Medications are stored on a high shelf which is inaccessible to children in care. Facility understands not to commingle with Elementary School children.

LPA reviewed sign-in and out sheet. The center has a complete record of sign-in/out sheets by an authorized pick up person. There are multiple first aid kits available. There is a working fire alarm system at the elementary. The each room has a working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available. All children have a record of emergency identification information. Staff records reviewed were complete. All staff has a criminal record clearance on file. The site Director and staff has a current Pediatric First Aid/CPR certificate on file. All staff has taken Mandated Reporter training.

see next page..

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022
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: EXTENDED DAY CHILD CARE - FREDERIKSEN
FACILITY NUMBER: 010214801
VISIT DATE: 10/19/2022
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During inspection,

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.

Incidental Medical Services (IMS) policy was discussed. This facility provide IMS (Incidental Medical Services) to children currently. If any IMS is provided, a Plan for Providing 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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No deficiencies were cited today.

A notice of site visit was given and must remain posted for 30 days

Exit interview conducted and report was reviewed with the director, Rosamaria Ochoa

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC809 (FAS) - (06/04)
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