013422426-8-28-2021-52-CC-JMIR-C6BSML-20210828140008

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422426
Report Date: 08/28/2021
Date Signed: 08/28/2021 02:00:40 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:	KIDDIE ACADEMY		FACILITY NUMBER:	013422426
ADMINISTRATOR:	BRUCE, SHANNON		FACILITY TYPE:	840
ADDRESS:	1400 N VASCO RD		TELEPHONE:	(925) 292-1948
CITY:	LIVERMORE	STATE: CA	ZIP CODE:	94551
CAPACITY:	14	CENSUS: 0	DATE:	08/28/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Marquita Gladney		TIME COMPLETED:	02:15 PM

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On 8/28/2021 Licensing Program Analyst (LPA) Jaylena Miller conducted an UNANNOUNCED ANNUAL REQUIRED INSPECTION. LPA met with Marquita Gladney, facility director and the facility was toured to conduct a Health and Safety Inspection. This program operates out of Room #4 (Ravens/School Age). The classroom was inspected for age appropriate furnishings, equipment, and adequate storage for children’s belongings. LPA observed the cleanliness of floors and surfaces, the presence of working carbon monoxide detector, smoke detectors/fire alarms and a fully charged fire extinguisher size 2A-10-BC that is accessible throughout the facility, the facility also passed an annual fire inspection on 8/17/2021. The bathroom has an age appropriate faucet and toilet, in working condition. The outdoor play area is fully fenced. There is padding under/around the climbing equipment. The play structures appear to be fully intact with no visual defects or concerns.

All required postings are present. The facility serves AM/PM snacks, menu is also posted. LPA reviewed storage of food and reminded director that food not in its original container needs to be labeled with expiration date. The storage of medication and medical equipment/supplies was also reviewed and is inaccessible to the children. There are no pools, hot tubs or other accessible bodies of water. Cleaning supplies/toxins are stored inaccessible to children. Per director, there are no firearms present on the premises.

A copy of the facility personnel roster and children’s roster was obtained. LPA reviewed the file of 10 children enrolled in the program and 2 staff members files, who are fingerprint cleared, completion of Mandated Reporter training as well as proof of immunization's. The opener, Assistant Director and the closer, Facility Director have current CPR/First Aid certificates that expire 8/17/2022 and 8/18/2021 respectfully, and proof of education and/or experience was also present. The center also conducts, and documents fire and earthquake drills and the logs show that drills were conducted on 1/26/2021 and was due for a fire drill in July 2021 and a Technical Violation is being cited today.

LPAs also discussed with the Director that ALL assistants, volunteers, frequent visitors, over the age of 18, must be fingerprint cleared and associated prior to being in the presence of children in care. An immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

Please see LIC 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jaylena Miller	TELEPHONE: (510) 292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2021

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: KIDDIE ACADEMY	FACILITY NUMBER: 013422426
	VISIT DATE: 08/28/2021

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Director was reminded of the responsibility as a mandated reporter and the trainings must be done once every two years as well as CPR/First Aid need to be renewed every two years and EMSA approved. LPA also encouraged the Director to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded.

Individual Medical Services (IMS) policy was discussed. The Director is reminded that when any changes to the IMS plan is made, an updated Plan for Providing 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 website at: http://www.ada.gov/childqanda.htm.

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

Effective August 1, 2003 California Law requires Child Care licensees 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 for (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

After a complete inspection of the facility, the attached Technical Violation was cited, See LIC 9102 - Technical Violation.

Exit interview was conducted with the facility director and the appeal rights were issued. A Notice of site visit was issued and must be posted for 30 consecutive days. A copy of this report is to remain in the facility records for three years.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jaylena Miller	TELEPHONE: (510) 292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2021

LIC809 (FAS) - (06/04)

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