010215763-12-6-2021-52-CC-RHAR-C9FTZ2-20211206140938

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010215763
Report Date: 12/06/2021
Date Signed: 12/06/2021 02:09:49 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:	HOLY SPIRIT PRESCHOOL		FACILITY NUMBER:	010215763
ADMINISTRATOR:	TARRANT, CECILIA		FACILITY TYPE:	850
ADDRESS:	3930 PARISH AVENUE		TELEPHONE:	(510) 793-2013
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY:	36	CENSUS: 28	DATE:	12/06/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Cecelia Tarrant		TIME COMPLETED:	02:18 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	On December 6, 2021 at approximately 9:30am, LPA Haderer arrived unannounced for an annual inspection for compliance to Health and Safety. The new CARE tool was used for the inspection. Present for the inspection was the site director Cecelia Tarrant, five teachers and 28 children in care ages 3 to 5. The center is in ratio today. The child care center operates on the campus of the Holy Spirit church and school grounds, in two large separate preschool classrooms (Caterpillar and Butterfly). Due to Covid precautions, a third classroom (Dragonfly) was granted a waiver and is operated in a separate building. The children have their own playground, all structures are in safe condition and free from sharp, loose or pointed parts. Areas around or under high climbing equipment has appropriate cushioned material that absorbs a fall. Children bring their own bottled water from home and the school also provides access to drinking water. The facility has fully charged 3A40BC fire extinguishers available throughout the building mounted inside of or next to each classroom door. The last annual inspection was done 11-16-2021. Arrow Fire Protection conducts fire inspections, the last inspection was completed 9/20/2020. Carbon monoxide detectors were tested and functioning. Heating and ventilation in the classrooms is acceptable. The facility is clean and well organized with ample age appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. Hazardous items/toxins are out of the access of children. There are no bodies of water accessible to children in care. Children bring their own food from home, the center provides snacks. Children use their own bathroom located in the Butterfly classroom (and for the temporary classroom Dragonfly, a dedicated bathroom right outside the door). There are enough towels and soap supplies. The staff have separate adult bathrooms.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: HOLY SPIRIT PRESCHOOL	FACILITY NUMBER: 010215763
	VISIT DATE: 12/06/2021

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
26
27
28
29
30
31
32

Disaster drills are conducted monthly, the last drill was conducted on November 10, 2021

The electronic sign in/out sheets were reviewed and are accurate. Classrooms have trash cans with tight fitting cover for the disposal of solid waste. There are one child at this time that needs IMS (inhaler). Medications were reviewed, not expired and held in the office of the school out of access to children.

Children's records were reviewed at 11:50am: LPA requested and reviewed facility roster. All files selected were complete and up to date.

Staff files were reviewed at 12:30pm. Opening and closing staff have current CPR and first aid training. All staff subjected to criminal review have been cleared and associated to the facility. All records complete and very organized.

All documents required to be posted were appropriately posted on the walls: License; Emergency Disaster Plan; Earthquake Preparedness checklist; Notification of Parents Rights; Personal rights; Child seatbelt laws; menus; daily activity schedules.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 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

Site 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.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: HOLY SPIRIT PRESCHOOL	FACILITY NUMBER: 010215763
	VISIT DATE: 12/06/2021

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
26
27
28
29
30
31
32

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/inspection-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 Site Director Cecelia Tarrant.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2021

LIC809 (FAS) - (06/04)

Page: 3 of 3