013414363-6-14-2019-02-CC-PPEN-BD5Q87-20190614115615

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013414363
Report Date: 06/14/2019
Date Signed: 06/14/2019 11:56:42 AM

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:	CHATHAM SCHOOL		FACILITY NUMBER:	013414363
ADMINISTRATOR:	PEREZ, VANESSA		FACILITY TYPE:	850
ADDRESS:	4359 - 39TH AVENUE		TELEPHONE:	(510) 531-1534
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94619
CAPACITY:	44	CENSUS: 36	DATE:	06/14/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Vanessa Perez		TIME COMPLETED:	12:05 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	Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced annual random site inspection for this facility on 06/14/19 at 0930. LPA met with and toured all areas utilized by children in care with facility director, Vanessa Perez. Also present at the time of this inspection were 36 preschool age children in care and five additional teaching staff. All teaching staff are background cleared and qualified teachers. The facility is within ratio and capacity. The Front Room, Circle Room, and Art Room were inspected for health and safety. Per director, there are no firearms present or stored on the premises. Classroom furniture is age appropriate and free of broken/sharp pieces. Surfaces including counter tops, tabletops and floors are free of toxins. There were no hazardous items/toxins observed to be accessible to children in care. All required postings are present. Children are under staff supervision at all times. There is a carbon monoxide detector, multiple smoke detectors and multiple fully charged fire extinguishers present. Per director, the most recent fire dept. inspection was May 2018. There are individual storage cubbies for children's personal belongings. Mats for napping are available and children's sleeping linens are individually labeled and laundered on site at least weekly. Indoor and outdoor drinking water is available with water jugs and cups and drinking fountains. The outside play area is fully fenced with age appropriate equipment which is free of broken/sharp pieces. Climbing equipment and slides are securely anchored with cushioning around and under the equipment. There are no pools or other accessible bodies of water present. This facility serves lunch and morning and afternoon snacks. There is a menu posted and available for review. Food storage and prep areas were inspected and appear clean and free of pests. Staff certification in CPR and First Aid is current and valid for multiple members present today. Facility, staff and children's files were reviewed including staff qualifications, background clearances, and immunization records and children's admissions agreements, immunization records and parents' rights forms. Teacher qualification forms were completed for two staff during this inspection. At 1050, LPA observed that there was one child present at the facility who was not signed in. This facility provide Incidental Medical Services-IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative records. LPA observed that children C1 and C2 did not have labels present for their prescription medications. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information 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 For forms and updates visit www.ccld.ca.gov. The attached Type B deficiencies were cited during this inspection. A copy of the appeals rights was issued and a Notice of Site Visit was printed and posted and is to remain posted for 30 consecutive days. A copy of this report shall be maintained for 3 years and available for public review upon request.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019

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: CHATHAM SCHOOL	FACILITY NUMBER: 013414363
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/14/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/01/2019 Section Cited CCR 101226(e)(1)(B)	1 2 3 4 5 6 7	101226(e)(1)(B) In centers where the licensee chooses to handle medications: Each container shall have an unaltered label. This facility was not in compliance with this requirement as evidenced by LPA's observation that there were not labels present for the prescription medications for children C1 and C2	1 2 3 4 5 6 7	This facility agrees to ensure that all prescription medications for children in care will have an unaltered label present going forward. In addition, the facility will provide verification of the presence of unaltered labels for prescription medications for children C1 and C2 or verification that the medications have been returned to the children's guardians and
	8 9 10 11 12 13 14	posing a potential risk to the health and safety of the children.	8 9 10 11 12 13 14	are no longer at the facility. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type B 07/01/2019 Section Cited CCR 101229.1(b)	1 2 3 4 5 6 7	101229.1(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This facility was not in compliance with this requirement as evidenced by LPA's observation that one child was present at the facility and was not signed in posing a potential risk to the health and safety of the child.	1 2 3 4 5 6 7	This facility agrees to ensure that going forward all children in care will be signed in and signed out as required. In addition the faciltiy will submit to licensing by the POC date, an up to date accurate sign in sheet for the child observed as not being signed in today. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations
	8 9 10 11 12 13 14		8 9 10 11 12 13 14	are $250 per violation and $100 per day until corrected.

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: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019

LIC809 (FAS) - (06/04)

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