010216054-1-21-2020-02-CC-LDYN-BL2U6W-20200121141900

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010216054
Report Date: 01/21/2020
Date Signed: 01/21/2020 02:19:05 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	PACIFIC RIM INTERNATIONAL SCHOOL		FACILITY NUMBER:	010216054
ADMINISTRATOR:	HUA KUANG, YAN		FACILITY TYPE:	850
ADDRESS:	5521 DOYLE STREET		TELEPHONE:	(510) 601-1500
CITY:	EMERYVILLE	STATE: CA	ZIP CODE:	94608
CAPACITY:	55	CENSUS: 34	DATE:	01/21/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Sandy Fong & Rita Tang		TIME COMPLETED:	02:30 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 1/21/20 at 9:20am, Licensing Program Analyst (LPA) Loretta Dyson arrived at the center for an unannounced random inspection. LPA met with Sandy Fong and Rita Tang, both Administrative Directors. There were 34 children and 6 additional staff also present. The preschool program, with a toddler option, is one component of this combination center which also has an infant program. The program operates Monday thru Friday 8am to 6pm, in 3 classrooms. An application was received in the Licensing office requesting an increase of capacity, and to change the classrooms that the program uses. LPA conducted a tour of the areas of the center that the preschool and toddler option programs currently use, and will use in the future, to conduct a health and safety inspection. These areas include the preschool classroom, classrooms listed as IC1, IC2, and IC3 to be used for the toddler option, the kitchen, three bathrooms, and the playground. The measurements are as follows: INDOORS: 2182.185 square feet = 62 children OUTDOORS: 8939.8 square feet = 119 children A fire clearance was received from Alameda County Fire Prevention, on 12/12/19, for a total capacity of 85 children. This capacity includes 31 preschoolers, 30 toddlers and 24 infants. LPA observed that the heating, lighting and ventilation in each classroom was sufficient for the safety and comfort of children and staff. LPA observed that all of the classroom floors, surfaces, furniture and equipment are clean, in good condition and safe. The furniture, equipment, toys and activities are age appropriate and there is an ample supply available for the number of children in care. There is a sufficient amount of storage space for children's belongings. LPA did not observe any bodies of water, disinfectants, cleaning solutions or medications accessible to children today. LPA observed that the toilets and sinks are accessible to children, and in sanitary and operational condition. LPA observed that all containers used for solid wastes had tight fitting covers on that were in good repair.

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: PACIFIC RIM INTERNATIONAL SCHOOL	FACILITY NUMBER: 010216054
	VISIT DATE: 01/21/2020

NARRATIVE

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The center is equipped with a working telephone, working carbon monoxide detector, centralized smoke/fire detection system with sprinklers, pull down fire alarm, fully charged 3A40BC fire extinguisher and ample first aid supplies. LPAs observed that the kitchen was clean and that food was not stored with cleaning supplies. There is drinking water available for children both indoors and outdoors. LPA observed that all required forms are posted and visible for public review, including the menu which is dated at least a week in advance. The center is using an electronic sign in and out procedure. LPA reviewed the fire/disaster drill log and it indicates the last drills were conducted on 1/15/20. LPA observed that the playground is fenced and has a shaded rest area, and the surface is in safe condition and free from hazards. The areas under the play structure are cushioned with a material that is sufficient to absorb a fall. LPA reminded the Licensee that the play structure should only be used for the children within the age group recommended by the manufacturer. There is a waiver in place for the shared use of the playground, and the center was reminded to adhere to the approved schedule.

LPA reviewed 3 children's files and 3 staff files. All staff have proof of the required qualifications in file and have been fingerprinted and associated to this facility. The licensee has provided proof that all staff have completed the required mandated reporter training. At least one opening/closing staff member has a current CPR/First Aid certificate. The facility is in ratio, and compliant with the capacity of the license today.

Ms. Fong stated that there are currently no children enrolled that require medication while in care. 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.

Licensee is reminded that ALL Staff must be fingerprint cleared and associated to the facility prior to being in the presence of children in care. Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

The center will be licensed today for a total of 61 preschoolers/toddlers, including 31 preschoolers using the preschool classroom and 30 toddlers using IC1, IC2 and IC3 classrooms. There are no deficiencies being cited today. This report shall remain on file for 3 years. A Notice of Site Visit was given and must remain posted for 30 days. An exit interview was conducted.

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

LIC809 (FAS) - (06/04)

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