013422052-10-21-2019-52-CC-BPLY-BH6TEV-20191021144034

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422052
Report Date: 10/21/2019
Date Signed: 10/21/2019 02:40:43 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	CASTRO VALLEY USD - STATE PRESCHOOL		FACILITY NUMBER:	013422052
ADMINISTRATOR:	TOMITA, JENNIFER		FACILITY TYPE:	850
ADDRESS:	4400 ALMA AVE		TELEPHONE:	(510) 537-3000
CITY:	CASTRO VALLEY	STATE: CA	ZIP CODE:	94546
CAPACITY:	24	CENSUS: 16	DATE:	10/21/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Jennifer Tomita		TIME COMPLETED:	03:00 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 10/21/19, LPA Briana Plumboy met with Director Jennifer Tomita for an unannounced random inspection. The center and playground were toured to conduct a Health and Safety inspection. There were 16 children present during the visit. Also present for the inspection was one teacher and 3 teacher assistants. The program currently offers two part day sessions from 8:30am until 11:30am, and 12:00pm until 3:00pm. This is a Title V center. The center has two waivers; one waiver is for the shared playground, and the other waiver is for the electronic sign in/out system. The center is in portable #7 which is safe, clean and in good repair during today's inspection. There is adequate storage for children's belongings. There is adequate furniture, toys, and activities which are age appropriate and in good condition. The heating and lighting appears to be adequate. There is drinking water readily available to children. There is a combined bathroom for boys and girls, which is separated by a half wall, and has curtains as a doorway which is accessible for children's use. All toilets flush properly, and there is running water, soap, and paper towels available for children to wash and dry their hands. There is a separate bathroom for staff. There are no bodies of water, or free standing water, accessible to children during today's inspection. Per teacher, there are no firearms on the premises of the child care center. Snacks are offered by the center and children's families can bring additional snacks. There are emergency snacks available. There is a menu posted. There are no cleaning supplies stored with food. The playground has safe and age appropriate equipment during today's inspection. All required documents are posted for public review. The center is in compliance with the sign in and out procedure. The center is equipped with a fully stocked first aid Kit, working telephone, carbon monoxide detector, pull down fire alarm and a 3A40BC fire extinguisher. Disaster drills are being conducted at least once every 6 months, and the log indicates the last one done was The Great California ShakeOut on 10/17/19. LPA observed the interaction between the staff and children in care, and found it to be in compliance with the Title 22 Regulations. All staff present have current CPR/First Aid, mandated reporter training certificates, and the required provider immunization's. All staff have been fingerprint cleared through Castro Valley School District. 1 staff file was reviewed. See 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2019

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: CASTRO VALLEY USD - STATE PRESCHOOL	FACILITY NUMBER: 013422052
	VISIT DATE: 10/21/2019

NARRATIVE

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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

California Law requires Child Care Centers to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list

Director was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL Staff must be fingerprint cleared prior to being in the presence of children in care, or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2019

LIC809 (FAS) - (06/04)

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