010216413-11-17-2022-52-CC-AWRT-CL9TL3-20221117134853

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010216413
Report Date: 11/17/2022
Date Signed: 11/17/2022 01:48:58 PM

Document Has Been Signed on 11/17/2022 01:48 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	BAY AREA CHILD CARE - AZEVADA		FACILITY NUMBER:	010216413
ADMINISTRATOR:	AMIRYAR, NADIA		FACILITY TYPE:	840
ADDRESS:	39450 ROYAL PALM DRIVE		TELEPHONE:	(510) 651-7041
CITY:	FREMONT	STATE: CA	ZIP CODE:	94538
CAPACITY:	50	CENSUS:	DATE:	11/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Nadia Amiryar		TIME COMPLETED:	02:00 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 November 17th, 2022 @ 11:45am Licensing Program Analyst (LPA) April Wright arrived for an unannounced Required-1 Year inspection, and met with on site director Nadia Amiryar. Present today were three (3) school age children (Kindergarten) present during the inspection. The facility is in ratio today. The facility was toured for a health and safety inspection. Hours of operation are Monday through Friday, 7:00am to 6:00pm. CLASSROOM: Program is located in a portable at Azevada Elementary school in the rear of the school campus. Program is for School-age Children, Kindergarten to 12 years of age per license The portable floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting for safety and comfort. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is the playhouse area which is away from other children in care. The center has smoke/carbon monoxide detectors, working telephone, a fully charged 2A10BC fire extinguisher in the classroom. BATHROOMS: The staff's bathroom is separate from the children's bathrooms. Children's restrooms are located across from portable on the main school campus. All sinks and faucets are in safe and sanitary operating condition. FOOD SERVICE: This facility provides breakfast, .lunch and snacks only to children in care. Center has food prep area that is clean and off limits to children in care. There are monthly menus posted at the facility. All storage containers for solid waste have tight fitting covers that are in good repair. OUTDOOR PLAY AREAS: Center shares play yards with Azevada school and is on a schedule. There are 2 play yards for the centers use, both have play structures with slides that has wood chips for cushioning to absorb falls and that is anchored for stability. There are no pools, hot tubs or other accessible bodies of water. Per Director there are no firearms/weapons present in the facility. See LIC809-C for continuance

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April Wright	TELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: BAY AREA CHILD CARE - AZEVADA	FACILITY NUMBER: 010216413
	VISIT DATE: 11/17/2022

NARRATIVE

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RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Three (3) children's files and two (2) staff files were reviewed along with director's file. All Staff files have required health screening and Employee Rights and all children files contain Identification & Emergency, Personal Rights, and Medical Consent forms. LPA reviewed the facility roster and obtained a copy. Mandated Reporter Training and CPR/First Aid certificates were reviewed and are up to date. The center is in compliance with the sign in and out procedure. Fire/Disaster drills are being conducted at least once every 6 months and the last one conducted was on 10/12 and 10/27/2022. All required documents are posted in a public accessible area.

California Law requires Family Child Care Home 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 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

Incidental Medical Services (IMS) policy was discussed. No IMS provided at facility. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When 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/inspection-process .

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.

There are no deficiencies 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 On site Director Nadia Amiryar

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April Wright	TELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

LIC809 (FAS) - (06/04)

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