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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010216194
Report Date: 06/16/2022
Date Signed: 06/16/2022 02:52:25 PM


Document Has Been Signed on 06/16/2022 02:52 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:DAVIS STREET CHILD CARE AT GARFIELD SCHOOLFACILITY NUMBER:
010216194
ADMINISTRATOR:PATTEN, MARYFACILITY TYPE:
840
ADDRESS:13050 AURORA DRIVETELEPHONE:
(510) 567-0322
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY:40CENSUS: 7DATE:
06/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Bonita SimmonsTIME COMPLETED:
02:51 PM
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On 06/16/2022 at approximately 1:45 PM, Licensing Program Analyst (LPA) Sabina Dodoo met with Site Director Bonita Simmons for an UNANNOUNCED ANNUAL REQUIRED INSPECTION for Davis Street Child Care at Garfield School. Present for the inspection were the Director and 2 teachers who are all fingerprint cleared. The total children enrolled are 14 and the census was 7 children at the time of the inspection. The Child Care Center is within ratio. The center is opened Monday through Friday from 8:30am to 5:30pm. The Child Care Center was toured to conduct a Health and Safety Inspection.


PHYSICAL PLANT: The entrance of the school is a door which leads to the entrance of the classroom. The center is located on the Garfield Elementary School campus. The center has a half day afternoon program for the school age children. The parents sign out in a binder located outside the door. The teachers pick the children at the school and sign them in the binder. There is one classroom for the school age program. There are two toilets that are in operable condition for children to use. The classrooms have cubbies with children’s names on them where personal items can be placed. The classrooms have chairs and tables equipped for children to use. The isolation area is the Director’s office. LPA observed the bulletin board (parent’s rights, emergency disaster plan, earthquake drills and facility license). All hazardous materials and toxins are kept out of reach from children and are not accessible. There is a fire extinguisher 3A 10 40 BC. There are multiple working smoke detectors, one carbon monoxide detector, a telephone and a fully stocked first aid kits. The furniture around the classroom and outdoor area are all child proof and adequate for children to use. The learning materials are organized, and toys are kept in safety bins and cabinets for easy access for the children.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2022
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: DAVIS STREET CHILD CARE AT GARFIELD SCHOOL
FACILITY NUMBER: 010216194
VISIT DATE: 06/16/2022
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FOOD & SNACK: The school provides afternoon snacks for the children. Water bottles are also provided to the children.

OUTDOOR: LPA Dodoo observed the outdoor area that has a play structure with a slide. There is tan bark all around the play structure to absorb falls. The outdoor play area is also fenced all around with secured gates. There are no bodies of water on the premises. There are no firearms on premises.


RECORDS: LPA reviewed 4 children’s files and 3 staff files(Site Director included) and documented them on LIC 859 and LIC 857. An updated roster was viewed by LPA. A copy was obtained by LPA from Site Director. The staff interview was completed with Site Director Bonita Simmons. The Director and staff have completed the Health and Safety training and CPR/First Aid is current. The Director and Staff are following the immunization laws and have completed the mandated reporter training. The Director has conducted and documented the fire and disaster drills twice a year and the last conducted drill was May 28th, 2022. All required forms are posted and visible for public view.

Incidental Medical Services (IMS) policy was discussed. This facility is not providing IMS (Incidental Medical Services) to children currently in care. 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.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
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: DAVIS STREET CHILD CARE AT GARFIELD SCHOOL
FACILITY NUMBER: 010216194
VISIT DATE: 06/16/2022
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Director was reminded that all adults 18 and over working in Child Care Center, 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 licensed 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Director was reminded of the responsibility as a mandated reporter and the trainings must be done once every two years as well as CPR/First Aid needs to be renewed every two years and must be EMSA approved. LPA also encouraged licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded. For licensing updates and Quarterly Child Care Distribution email, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Effective August 1, 2003 California Law requires Child Care licensees 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 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624 within 7 business days.

There are no deficiencies cited during today’s inspection. A notice of site visit was given and must remain posted for 30 days. Exit Interview and staff interview was conducted with Site Director (Bonita Simmons). This report shall remain on file for the next 3 years.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC809 (FAS) - (06/04)
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