013417856-10-3-2023-52-CC-JJAN-CW9T6E-20231003142700

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013417856
Report Date: 10/03/2023
Date Signed: 10/03/2023 02:27:21 PM

Document Has Been Signed on 10/03/2023 02:27 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	PEACE TERRACE ACADEMY		FACILITY NUMBER:	013417856
ADMINISTRATOR:	ROOHI QADIR		FACILITY TYPE:	850
ADDRESS:	33330 PEACE TERRACE		TELEPHONE:	(510) 477-9946
CITY:	FREMONT	STATE: CA	ZIP CODE:	94555
CAPACITY:	29	CENSUS: 23	DATE:	10/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Roohi Qadir		TIME COMPLETED:	02:30 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 10/03/2023 at 9:55AM Licensing Program Analyst (LPA) Jaleesa Jackson arrived for an Unannounced Annual Inspection and met with Director Roohi Qadir. There were 23 preschool aged children and four (4) fingerprint cleared staff members 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 Thursday 8:00AM to 3:15PM and 8:00AM to 12:00PM on Fridays. The preschool consists of three classrooms and one common area for eating. At 10:05AM all classrooms were tour. There are adequate play and learning materials available. There is adequate heating/air conditioning, ventilation and lighting and working telephones. Children bring their own water bottle from home and are refilled if needed. Director stated that the center has not completed their lead testing. There is proper individual storage space for each child. The isolation area for sick children is the common area between the classrooms away from other children in care. The center has a fully charged fire extinguisher and working three carbon monoxide smoke detector. Each classroom has an emergency disaster backpack as well as fully stocked first aid kits. Napping equipment was observed to be in good condition and labeled with each child's name. The children take an hour of nap 4 times a week except Fridays, which it is a minimum day for the children. Blankets and bedding are given to parents every Thursday to clean. The facility conducts monthly fire drills and last fire drill was conducted on September 28, 2023. The staff's bathrooms are separate from the children's bathrooms. All sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets with stepping stools available. There is also a physical divider between each toilet to provide privacy to each child. The center does not provide snacks or lunch. All children bring lunch and snacks from home. There is a weekly menu for parents to bring items for the center to provide breakfast to the children. The center is a nut free facility. All storage containers for solid waste have tight fitting covers that are in good repair. Continued on 809-C

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa Jackson	TELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PEACE TERRACE ACADEMY	FACILITY NUMBER: 013417856
	VISIT DATE: 10/03/2023

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
26
27
28
29
30
31
32

LPA Jackson observed the outdoor play area. The outdoor has play structure with a slide that has cushioning to absorb falls and that is anchored for stability. There's also plenty of trees that provides shade to children while at play. The Director stated that the right side yard is OFF limits to children. Staff also inspects the play area before any children plays outdoor as the play yard is shared with Sunday school organized by Islamic Society of East Bay (ISEB).

At 11:15AM five children and five staff files were reviewed. Two staff members are have expired mandated reporter. During file review LPA observed a child going into a classroom without supervision while the other children were in the common area. LPA asked staff if there was another teacher in the classroom the child went into. Teacher stated no they are putting their lunch box away. LPA reminded teacher that all preschool students require full supervision when in care. All required documents are posted in a public accessible area. LPA gave Director a copy of their waivers. Director stated they do note use them. During inspection several school aged children were using the preschool bathroom. LPA informed Director that these waivers still need to be posted. The center does provide IMS and all medication was reviewed by LPA.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Continued on 809-C

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa Jackson	TELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC809 (FAS) - (06/04)

Page: 2 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PEACE TERRACE ACADEMY	FACILITY NUMBER: 013417856
	VISIT DATE: 10/03/2023

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
26
27
28
29
30
31
32

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE

LPA referred licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care- centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Roohi Qadir.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa Jackson	TELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC809 (FAS) - (06/04)

Page: 3 of 6

Document Has Been Signed on 10/03/2023 02:27 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PEACE TERRACE ACADEMY	FACILITY NUMBER: 013417856
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/03/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above by not completing the lead test for drinking water which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/03/2023
	Plan of Correction
1 2 3 4	Complete lead test and submit all required documents to LPA by end of business day on 11/3/2023 by email. LPA has included what documents are required from the PIN.

Type B

Section Cited

CCR

101229(a)(1)

Responsibility for Providing Care and Supervision

(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above one child went into a classroom without supervision which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/10/2023
	Plan of Correction
1 2 3 4	Director will have a staff meeting and all staff watch the Supervising Children in Child Care Centers video from the CDSS website. Director will submit the agenda for the meeting with sign in for each teacher as well as a brief statement from all staff on how they plan on maintain 100% supervision for children by email before end of business day 10/10/2023.

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: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa Jackson	TELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC809 (FAS) - (06/04)

Page: 4 of 6

Document Has Been Signed on 10/03/2023 02:27 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PEACE TERRACE ACADEMY	FACILITY NUMBER: 013417856
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/03/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in 2 out of 5 staff have expired Mandated Reporter which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/10/2023
	Plan of Correction
1 2 3 4	Both staff will complete mandated reported and submit to LPA by end of business day 10/10/2023 by email.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa Jackson	TELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC809 (FAS) - (06/04)

Page: 5 of 6