013413922-7-22-2021-52-CC-RHAR-C56VQM-20210722163834

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013413922
Report Date: 07/22/2021
Date Signed: 07/22/2021 04:38:42 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:	NURTURE KIDS PRESCHOOL		FACILITY NUMBER:	013413922
ADMINISTRATOR:	RELAN, SHASHI		FACILITY TYPE:	850
ADDRESS:	38000 CAMDEN STREET		TELEPHONE:	(510) 797-2222
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY:	53	CENSUS: 8	DATE:	07/22/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Ruby Masih		TIME COMPLETED:	04:55 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 July 22, 2021 at approximately 12:40pm Licensing Program Analyst (LPA) Russ Haderer arrived to conduct an unannounced random annual site inspection for this preschool facility. LPA met with facility director, Ruby Masih and toured all areas licensed for use by children in care for a health and safety inspection. Also present at the time of this inspection was 1 teacher and 8 children in care (all preschool age). During the visit, 1 additional volunteer arrived. The facility is within ratio and capacity. Other than the volunteer, all adults present are background cleared and associated to this facility. The facility is a single story building with a patio area and a large playground in the back. There are two sister schools operating at this location, the other facility (013413923) is a single room for school age children and temporarily not operating during covid. The preschool (013413922) consists of 3 classroom rooms: Little Fish; Lions 1 and Lions 2. It has a shared bathroom with 5 working toilets and sinks (one sink is not in use at this time), an outside playground area and a kitchen for food prep containing a refrigerator, stove, dishwasher and area for dry goods storage. The food prep kitchen area is off limits to children, there were no sharp knives observed in the kitchen today. Cleaning chemicals and other cleaners are stored out of reach of children. There are two 2A10BC fire extinguishers fully charged and last serviced on Feb 2021, one in the kitchen prep area and one in Lions 1. The rooms have working smoke detectors and carbon monoxide detectors in the ceilings. There is one restrooms for staff, separate from the children's restrooms. Heating and ventilation is acceptable.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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: NURTURE KIDS PRESCHOOL	FACILITY NUMBER: 013413922
	VISIT DATE: 07/22/2021

NARRATIVE

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The school does not currently provide any lunch or snacks, the children bring their food and their own water bottles from home. There is emergency snack food available if a child forgot theirs or did not like what they brought from home.

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. There were no hazardous items/toxins observed to be accessible to children in care today. There are no bodies of water accessible to children in care. All hazardous materials and toxins are kept out of the reach of children.

Disaster drills are conducted once per month, the last drill was conducted June 8, 2021.
There are sufficient amount of towels, soap and diaper supplies. All toilets, hand washing and cleaning areas are in safe and sanitary operating condition.

The facility uses an electronic sign in/out tablet. All children present were signed in. Classrooms have touchless trash cans with tight fitting cover for the disposal of solid waste. The facility does not have any children that require incidental medication (EpiPen’s, inhalers and anti-histamines for allergies).

The children's napping areas are clean and organized with sleeping pads and cubbies for the children's personal items, none of the children's blankets were touching.

There is a large playground area surrounded by a 6 foot privacy fence and secured with gates with inside latches too high for children to reach. All play equipment is in safe condition and free from sharp, loose or pointed parts and the areas around or under high climbing equipment has appropriate cushioned material that absorbs a fall. Shade was available in the play areas and teachers are always present. Children bring their own bottled water from home and it is made available to them.

All required posted documents were found to be in compliance and prominently posted in public places.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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: NURTURE KIDS PRESCHOOL	FACILITY NUMBER: 013413922
	VISIT DATE: 07/22/2021

NARRATIVE

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At approximately 2:06pm LPA performed children's record reviewed: LPA requested and reviewed facility roster. LPA noted that Physician's Report with documentation of TB tests were missing for 2 children's files. See LIC809-D for explanation of deficiencies. All other files selected were complete and found to be in compliance with Title 22 regulations.

At approximately 2:25 pm LPA performed staff file review. All staff subjected to criminal review have been cleared and associated to the facility. CPR/1st Aid for site director is current and expires 11/16/2023. Mandated Reporter certificate for center director had expired in September 2020. See LIC809-D for explanation of deficiency. All other records were complete, up to date and found to be in compliance with Title 22 regulations.

Deficiencies were found during inspection of records during today’s inspection. See LIC809-D for explanations of deficiencies.

Appeal rights were printed and provided to Site Director, a Notice of Site Visit was printed and must remain posted for 30 days. An exit interview was conducted.

A copy of this report to remain on file for 3 years. .

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: NURTURE KIDS PRESCHOOL	FACILITY NUMBER: 013413922
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/22/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/22/2021 Section Cited	1 2 3 4 5 6 7	101220 Child's Medical Assessments (a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment....
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on observation and interview the licensee did not ensure the child's files were complete (including medical assessments) which poses a potential risk to children in care.	8 9 10 11 12 13 14
Type B 07/22/2021 Section Cited	1 2 3 4 5 6 7	101220 Child's Medical Assessments (b) The medical assessment shall provide the following: (2) Results of a test for tuberculosis.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on observation and interview the licensee did not ensure the child's files were complete (including medical assessments and TB test results) which poses a potential risk to children in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

LIC809 (FAS) - (06/04)

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