013419457-8-7-2024-02-CC-DCAS-D7X2QR-20240807173623

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013419457
Report Date: 08/07/2024
Date Signed: 08/07/2024 05:36:38 PM

Document Has Been Signed on 08/07/2024 05:36 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	PETER PAN ACADEMY		FACILITY NUMBER:	013419457
ADMINISTRATOR:	CLEMENT, THERESA		FACILITY TYPE:	830
ADDRESS:	3171 MECARTNEY ROAD		TELEPHONE:	(510) 523-5050
CITY:	ALAMEDA	STATE: CA	ZIP CODE:	94502
CAPACITY:	11	CENSUS: 8	DATE:	08/07/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Teresa Clement		TIME COMPLETED:	05:45 PM

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On 8/7/24 at 3:00 PM, Licensing Program Analyst (LPA) D. Campos arrived at the facility for the purpose of conducting an Annual Random inspection. LPA was granted access to the facility and met with Center Director Theresa Clement. Present during this inspection were 8 infants and 3 staff. The facility operates Monday-Friday 7:30am - 5:30pm.

LPA toured the physical plant with Director Theresa Clement for a health and safety inspection. LPA observed one classroom, sleeping/crib area, a shared kitchen and an outdoor play area that is separate from the preschool program. Facility is within ratio during today's inspection.

Rooms, restrooms, and in use areas were inspected. Food and feeding bottles were labeled and stored safely. Food storage areas were sanitary, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. Napping area had cribs and was separate from the activity area. The infant changing pad has raised sides that are at least 3 inches in height, has a vinyl changing pad that is at least 1 inch thick and in good condition. Napping equipment is appropriate. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Cabinets, drawers, and rooms used for storage were locked. Floors were clean and free from tripping hazard.

LPA observed a working fire extinguisher, smoke and carbon monoxide detectors.

Emergency disaster log shows that the last fire/earthquake drill was conducted on 7/25/2024.

See LIC809C----------------------------------------------------------------------------------------------

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

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: PETER PAN ACADEMY	FACILITY NUMBER: 013419457
	VISIT DATE: 08/07/2024

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Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles.
Facility’s License, Parents’ Rights Poster PUB 393, Personal Rights, Activity Schedules, and were observed to be posted.

Outdoor activity space was inspected and observed to be fenced and safe. The play equipment is age appropriate and maintained in good condition and free of hazards. Shade is provided.

There were no bodies of water observed. Drinking water is arranged to be readily available to children during indoor and outdoor activities via personal labeled bottles.

Sign in and out procedures and logs were reviewed. A sampling of Infant and Staff files was taken for review. LPA reviewed the Needs and Services Plan for all infants which were updated quarterly. Reviewed Individual Safe Sleep Plan Sleep Log for each infant.

There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection. A copy of Children Roster and Personnel Report was obtained.

On or before March 30, 2018 any person who works in a child care facility shall complete Mandated Reporter training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. Review of staff files show that staff has completed Mandated Reporter training.

LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility 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.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

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: PETER PAN ACADEMY	FACILITY NUMBER: 013419457
	VISIT DATE: 08/07/2024

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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. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Director 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.

Director 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.

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.

There were no deficiencies cited during today's inspection.

Exit interview conducted with Director Theresa Clement.
A Notice of Site Visit was provided and must remain posted for 30 days.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

LIC809 (FAS) - (06/04)

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