013421377-1-21-2020-02-CC-LDYN-BL2U62-20200121141737

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421377
Report Date: 01/21/2020
Date Signed: 01/21/2020 02:17:43 PM

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:	PACIFIC RIM INTERNATIONAL SCHOOL		FACILITY NUMBER:	013421377
ADMINISTRATOR:	WILLIAMSCRAIG, LISA		FACILITY TYPE:	830
ADDRESS:	5521 DOYLE ST		TELEPHONE:	(510) 601-1500
CITY:	EMERYVILLE	STATE: CA	ZIP CODE:	94608
CAPACITY:	12	CENSUS: 7	DATE:	01/21/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Sandy Fong & Rita Tang		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 1/21/20 at 9:20am, Licensing Program Analyst (LPA) Loretta Dyson arrived at the center for an unannounced 1 year required inspection. LPA met with Sandy Fong and Rita Tang, both Administrative Directors. There were 7 infants and 3 additional staff also present. The infant program is one component of this combination center which also has a preschool program with a toddler option. The program operates Monday thru Friday 8am to 6pm, in 1 classroom. An application was received in the Licensing office requesting an increase of capacity, and to change the classrooms that the program uses. LPA conducted a tour of the areas of the center that the infant program currently uses, and will use in the future, to conduct a health and safety inspection. These areas include classrooms listed as ND1 and ND2, the bathroom between these classrooms, the kitchen and the playground. The measurements are as follows: INDOORS: 1075.91 square feet = 31 children OUTDOORS: 9634.39 square feet = 128 children A fire clearance was received from Alameda County Fire Prevention, on 12/12/19, for a total capacity of 85 children. This capacity includes 24 infants, 31 preschoolers and 30 toddlers. LPA observed that the classroom floors, surfaces and equipment are clean, free from hazards, and free from toxic substances. LPA observed that the heating, lighting and ventilation is sufficient for the safety and comfort of children and staff. The napping areas are separate from the activity space. The activities, equipment and storage are age appropriate and sufficient for the number of children in care. The changing table was clean and within arms reach of a sink. There are 4 sinks available, which are in sanitary and operational condition. The bottles and food brought from home are labeled and stored appropriately. LPA did not observe any bodies of water, disinfectants, cleaning solutions or medications accessible to children today.

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

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: PACIFIC RIM INTERNATIONAL SCHOOL	FACILITY NUMBER: 013421377
	VISIT DATE: 01/21/2020

NARRATIVE

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The center is equipped with a working telephone, working carbon monoxide detector, centralized smoke/fire detection system with sprinklers, pull down fire alarm, fully charged 3A40BC fire extinguisher and ample first aid supplies. LPA observed that the kitchen was clean and that food was not stored with cleaning supplies. There is drinking water available for children both indoors and outdoors. LPA observed that all required forms are posted and visible for public review, including the menu which is dated at least a week in advance. The center is using an electronic sign in and out procedure. LPA reviewed the fire/disaster drill log and it indicates the last drills were conducted on 1/15/20.

The playground has a fenced space that is used to separate infants when the older children are on the yard, but the infant program can utilize the shared space on different schedules. There is a waiver in place for the shared use of the playground, and the center was reminded to adhere to the approved schedule. LPA reminded the Licensee that the play structure should only be used for the children within the age group recommended by the manufacturer.

LPA reviewed 3 children's files and 3 staff files. All staff have proof of the required qualifications in file and have been fingerprinted and associated to this facility. The licensee has provided proof that all staff have completed the required mandated reporter training. At least one opening/closing staff member has a current CPR/First Aid certificate. The facility is in ratio, and compliant with the capacity of the license today.

Ms. Fong stated that there are currently no children enrolled that require medication while in care. 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.

Licensee is reminded that ALL Staff must be fingerprint cleared and associated to the facility prior to being in the presence of children in care. Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

The center will be licensed today for a total of 24 infants, using ND1 and ND2 classrooms. There is sufficient space for 8 crib age children. There are no deficiencies being cited today. This report shall remain on file for 3 years. A Notice of Site Visit was given and must remain posted for 30 days. An exit interview was conducted.

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

LIC809 (FAS) - (06/04)

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