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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422039
Report Date: 07/26/2023
Date Signed: 07/26/2023 03:01:24 PM


Document Has Been Signed on 07/26/2023 03:01 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:EXTENDED DAY CHILD CARE AT AMADORFACILITY NUMBER:
013422039
ADMINISTRATOR:SALGADO, KATRINAFACILITY TYPE:
840
ADDRESS:2100 E. CANTARA DRIVETELEPHONE:
(925) 560-8191
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:215CENSUS: 62DATE:
07/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Director, Katrina SalgadoTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Jyoti Saini met with facility representative, Katrina Salgado for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the director. Present during the inspection, 11 staff members supervising 62 children. The program consists of two sessions: 7:00 am to 8:15 am and 12:00 pm to 6:00 pm Monday - Friday in room EDCC #101 (AKA owls ages K-1st grade) and room # EDCC 101 (AKA falcon ages 2nd grade to 5th grade) on the AMADOR ELEMENTARY SCHOOL CAMPUS. The facility currently operating summer program: Monday – Friday,7:00am to 6:00pm.
The facility was inspected indoor and outdoor today for health and safety hazards and the following was observed; There are no bodies of water, firearms, or weapons on the premises. The center is in good condition with proper temperature and ventilation and is free of any hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. The boys and girls have separate bathrooms, and each bathroom has three toilets and two sinks. The staff have a separate bathroom. The bathrooms appear to be safe, sanitary, and free of any hazardous items. There is drinking water readily available through water fountain and water bottles brought from home. There is a menu posted for the entire month. The facility serves snacks and requires children to bring their own lunch. LPA reviewed storage of food and observed that food is in original packaging and labeled with expiration date.
The classroom has appropriate postings. The last Emergency Drill was conducted on 06/30/2023 and is properly logged. Outdoor play area was free of hazards and provided a shaded area for the children. Medications are stored on a high shelf which is inaccessible to children in care. Facility understands not to commingle with Elementary School children.

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SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:
DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/26/2023
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: EXTENDED DAY CHILD CARE AT AMADOR
FACILITY NUMBER: 013422039
VISIT DATE: 07/26/2023
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The facility uses electronic sign in and sign out system, KT connect. The center has a complete record of sign-in/out sheets by an authorized pick-up person. There are multiple first aid kits available. There is a working fire alarm system at the elementary. The room has a working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available. All children have a record of emergency identification information. Staff records reviewed were complete. All staff has a criminal record clearance on file. The site Director and staff has a current Pediatric First Aid/CPR certificate on file. All staff has taken Mandated Reporter training.

During inspection,

Criminal Record Clearance -

Facility representative 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.

Incidental Medical Services (IMS)


This facility provides Incidental Medical Services – IMS. 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/.

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SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: EXTENDED DAY CHILD CARE AT AMADOR
FACILITY NUMBER: 013422039
VISIT DATE: 07/26/2023
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MyChildCarePlan.org
Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare 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.

No deficiency was cited Today.



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


Exit interview conducted and report was reviewed with the facility representative, Katrina Salgado
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3