013414235-2-13-2020-52-CC-RRED-BLS4X3-20200213182853

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013414235
Report Date: 02/13/2020
Date Signed: 02/13/2020 06:29:00 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:	MY SPACE TO GROW		FACILITY NUMBER:	013414235
ADMINISTRATOR:	CASTAIN, CYNTHIA		FACILITY TYPE:	830
ADDRESS:	7197 AMADOR VALLEY BOULEVARD		TELEPHONE:	(925) 829-4063
CITY:	DUBLIN	STATE: CA	ZIP CODE:	94568
CAPACITY:	8	CENSUS: 7	DATE:	02/13/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:05 PM
MET WITH:	Cynthia Castin		TIME COMPLETED:	06:30 PM

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02/13/2020 at approximately 2:05PM Licensing Program Analysts Renee Reed, Lisa Clayton and Licensing Program Manager Chandra Charles, met with Director Cynthia Castin for the purpose of conducting an Unannounced Required Site Inspection of the Infant Center for this combination day-care center. Present during the inspection was one Infant teacher, one teacher aid and 7 infants. Staff-infant ratios was observed. All staff (Lead Teacher & the Director) subjected to criminal record review or criminal record exemption have been cleared and associated to this facility.

The LPA's and LPM toured the infant center to conduct a Health & Safety inspection. PHYSICAL PLANT - The Infant Center program is conducted in the two rooms to the back of the facility. LPA's observed the facility was be clean, safe, sanitary and in good repair. All hazardous materials and toxins are kept out of the reach of children.
The furniture and equipment are all age apporipate and in good condition, free of sharp, loose or pointed parts. All floors were clean and safe. The facility has indoor activity space for infants. There is more that one working carbon monoxide detector in the facility. The changing tables are clean and within arm’s reach of a sink.

STAFF AND CHILDREN'S FILES: 2:35PM, A review of (6) children and (2) staff records was conducted. All required documentation for staff and children were in the files. LPA reviewed the Mandated Reporter training certificates for all of the infant personnel staff. This facility is in compliance with this training.

LPA reviewed and obtain a copy of the current facility roster.

FOOD SERVICE AREAS: The food preparation and storage areas are clean. Parents provide food for infants who are not on solid food. LPA's observed infants foods were labelled and properly stored in the refrigerator. All storage containers for solid waste had tight-fitting covers that are kept on and in good repair. There is a snack menu post on the parent board.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee Reed	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: MY SPACE TO GROW	FACILITY NUMBER: 013414235
	VISIT DATE: 02/13/2020

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INSPECTION of OUTDOOR PLAY AREA: Infant's outdoor activity space surfaces are free of hazards. The areas around or under high climbing equipment has appropriate cushioned material that absorbs a fall. The facility has age appropriate furniture, equipment, and toys that appear to be safe and in good condition.

NAPPING EQUIPMENT: There are ample cribs/cots available for children's use. Bedding, and sheets are stored properly. LPA observed napping children are properly being supervised.

POSTING REQUIREMENTS: All proper documents that need to be posted are posted in a highly visible place for parental review. Disaster Drills are being practiced at least once every 6 months with the last one being conducted 12/16/2019.

CARE & SUPERVISION: area of the Infant Center to ensure proper ratios and compliance with capacity limits. Child teacher interactions were observed and found to be in accordance with regulations. No children's rights were being violated. All children were treated with dignity and respect. At least (3) persons on staff has current CPR/First Aid. Health Related Services: Children's medication properly labeled and stored in original container. Currently there are two children on medication.

The Director is reminded that ALL assistants, volunteers, frequent visitors, or adults at the facility, are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Director was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov.

There are no deficiencies cited. A notice of site visit was given and is required to be posted for 30 days. This report shall remain on file for 3 years. Exit interview conducted .

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee Reed	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

LIC809 (FAS) - (06/04)

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