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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419449
Report Date: 12/14/2022
Date Signed: 12/14/2022 01:59:54 PM


Document Has Been Signed on 12/14/2022 01:59 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:ABC MAGIC MOMENTS PRESCHOOL - IRVINGTONFACILITY NUMBER:
013419449
ADMINISTRATOR:MENDEZ, MAROOFFACILITY TYPE:
850
ADDRESS:4600 CAROL AVE.TELEPHONE:
(510) 585-5965
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY:80CENSUS: 70DATE:
12/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Maroof MendezTIME COMPLETED:
02:00 PM
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On December 14th, 2022 @ 10:15am, Licensing Program Analyst (LPA) April Wright arrived for an unannounced Required-1 Year inspection, and met with Director Maroof Mendez. Present today were Seventy (70) preschool and Kindergarten children and ten (10) 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 Friday, 7:30am to 5:00pm.

CLASSROOMS: Center has 2 buildings that house each program. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting for safety and comfort. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is the director's office, away from other children in care. The center has smoke/carbon monoxide detectors, working telephone, and 3 fully charged 3A40BC fire extinguishers. At least one person trained in CPR/First aid is present at the facility when children are at the facility.

BATHROOMS: The staff's bathroom is separate from the classroom and are clean, sanitary and in good condition. All sinks and faucets are in safe and sanitary operating condition. .

FOOD SERVICE AREAS: This facility provides breakfast and snack to children in care. There are weekly menus posted at the facility. All storage containers for solid waste have tight fitting covers that are in good repair Facility has a refrigerators which is clean and free of evidence of rodents, vermin or insects.

OUTDOOR PLAY AREAS: There are 1 play structure with slide, sandbox with cover and a gazebo that has wood chips/grass for cushioning to absorb falls and that is anchored for stability. There's also a canopy over the gazebo that provides shade to children while at play. There are no pools, hot tubs or other accessible bodies of water. Per Director, there are no weapons or firearms present at facility. See LIC809C for continuance.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2022
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ABC MAGIC MOMENTS PRESCHOOL - IRVINGTON
FACILITY NUMBER: 013419449
VISIT DATE: 12/14/2022
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RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Ten (10) random children's files and ten (10) staff files were reviewed, along with director's file. All staff files have required health screening and Employee Rights and all children files contain Identification & Emergency, Personal Rights, and Medical Consent forms. LPA reviewed the facility roster and obtained a copy. Mandated Reporter Training and CPR/First Aid certificates were reviewed and are up to date. The center is in compliance with the sign in and out procedure. Disaster drills are being conducted at least once every 6 months and the last one conducted was on November 18th and 29th. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: IMS IS PROVIDED AT THIS FACILITY. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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/inspection-process .

Director was reminded that all adults 18 and over, 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 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.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Maroof Mendez.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC809 (FAS) - (06/04)
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