013414632-10-14-2022-52-CC-SDOO-CK7Q3V-20221014114921

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013414632
Report Date: 10/14/2022
Date Signed: 10/14/2022 11:49:40 AM

Document Has Been Signed on 10/14/2022 11:49 AM - 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:	PRINCIPLED ACADEMY, THE		FACILITY NUMBER:	013414632
ADMINISTRATOR:	FLORENDO, AURELIA		FACILITY TYPE:	850
ADDRESS:	2305 WASHINGTON AVENUE		TELEPHONE:	(510) 351-6400
CITY:	SAN LEANDRO	STATE: CA	ZIP CODE:	94577
CAPACITY:	47	CENSUS: 13	DATE:	10/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Aurelia Florendo		TIME COMPLETED:	11:55 AM

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 Friday 10/14/2022 at approximately 8:45AM, Licensing Program Analyst (LPA) Sabina Dodoo met with Director Aurelia Florendo for an UNANNOUNCED ANNUAL REQUIRED INSPECTION for The Principled Academy. Present for the inspection was the Director who is fingerprint cleared and 3 additional staff who are also fingerprint cleared and associated. The total enrolled children are 47 and the census was 13 children at the time of the inspection. The Child Care Center is opened Monday through Friday from 7:00am to 6:15pm. The Child Care Center was toured to conduct a Health and Safety Inspection. PHYSICAL PLANT: The entrance of the school is a large gate that leads to the school. There is also a smaller gate by the play area that leads to the portable classrooms. The parents sign in and out on paper in a binder at the classroom door. LPA reviewed the sign in and sign out sheet provided by Director. There are three rooms: Gold Room, Green Room, and Blue Room. Green Room and Blue Room are the portable classrooms. The Gold room is located in the school and church facility building that has double doors. LPA observed cubbies with children’s names where personal items are kept. LPA observed sleeping mats used for napping. There is a bathroom that has sinks and toilets in operable conditions for children to use. The isolation area is the Gold Room. LPA observed the bulletin board (parent’s rights, emergency disaster plan, earthquake drills, facility license, Child passenger restraint poster and menu). All hazardous materials and toxins are kept out of reach from children and are not accessible. There are multiple fully charged fire extinguishers 3A 10 40 BC located in the classrooms and hallway. There is one working carbon monoxide detector, multiple working smoke detectors, a telephone, and first aid kits in the classroom. The furniture around the classrooms and outdoor area are all child proof and adequate for children to use. There are ample amounts of toys available for children to play with. The classrooms have storage areas to keep the toys for easy access for the children.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina Dodoo	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022

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: PRINCIPLED ACADEMY, THE	FACILITY NUMBER: 013414632
	VISIT DATE: 10/14/2022

NARRATIVE

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FOOD & SNACK: The school provides AM/PM snacks. Children bring lunch from home that are warmed in the microwave located in the classroom if necessary. Children also bring personal water bottles from home labeled with names. The school provides water and refill the bottles as needed. Children also bring their water bottles outside during play time.

OUTDOOR: LPA Dodoo observed the outdoor play area which consist of a play structure with a slide. The play structure is affixed to the ground and has tan bark material to absorb falls. There is also a sandbox free of debris with a cover. There are two playhouses and an area with bikes where children can ride. 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 6 children’s files and 4 staff files( Director Included) and documented them on LIC 859 and LIC 857. An updated roster was viewed by LPA. A copy was provided to LPA by Director. The staff interview was completed with Director Aurelia Florendo. 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. The last conducted drill was August 3^rd’ 2022. All required forms are posted and visible for public view.

Incidental Medical Services (IMS) policy was discussed. This facility is providing IMS (Incidental Medical Services) to children currently in care. LPA observed medication that is unexpired and the prescription label is unaltered. If any IMS(Incidental Medical Services) 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 Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina Dodoo	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022

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: PRINCIPLED ACADEMY, THE	FACILITY NUMBER: 013414632
	VISIT DATE: 10/14/2022

NARRATIVE

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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. A copy of Appeal Rights was provided. Exit Interview was conducted with Director(Aurelia Florendo). This report shall remain on file for the next 3 years.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina Dodoo	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022

LIC809 (FAS) - (06/04)

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