013423130-3-24-2022-02-CC-MDOY-CCTPLT-20220324112517

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423130
Report Date: 03/24/2022
Date Signed: 03/24/2022 11:25:35 AM

Document Has Been Signed on 03/24/2022 11:25 AM - 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:	ARBOR PRESCHOOL COLLEGE		FACILITY NUMBER:	013423130
ADMINISTRATOR:	JOHNSTON, KELLY		FACILITY TYPE:	850
ADDRESS:	5830 COLLEGE AVENUE		TELEPHONE:	(360) 461-6466
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94618
CAPACITY:	34	CENSUS: 0	DATE:	03/24/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Rebecca Lidow and Kelly Johnston		TIME COMPLETED:	11:40 AM

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	A Prelicensing Visit was conducted today 3/24/2022 by Licensing Program Analysts (LPAs), Melissa Domantay, Melissa Guirit, and Indira Loza. LPAs met with applicants Rebecca Lidow and Kelly Johnston. The applicants submitted an application for a preschool license. A health and safety inspection was conducted inside and outside. The preschool program will operate in 4 classrooms, Monday to Friday from 8:00am-5:00pm. The measurements are as follows: INDOORS: 1206.37 square feet = 34 children OUTDOORS: 3353.4 square feet = 45 children A fire clearance, with a total capacity of 34 preschool children, ages 2 years to first grade entry was received from the Oakland Fire Department. LPAs observed that the classrooms has sufficient lighting and appears to be clean and in good condition. LPAs observed an ample supply of age appropriate activities, equipment and furniture. The facility has 3 toilets and 4 sinks. The classroom has a fully charged 2A10BC fire extinguisher, working fire alarm and carbon monoxide detector, and applicants will send a photo of the first aid supplies to LPA Domantay. There is a working telephone at the center. LPAs did not observe any hazardous items that would be accessible to children. Facility will provide drinking water for children indoors and outdoors, children will be bring individual reusable bottles. Lunch will be provided by children's families and snacks will be provided at the center. The isolation room will be used for ill children as the isolation area. LPAs observed the 2 outdoor play areas, they are fully fenced and have amply supply of age appropriate activities, equipment, and furniture. Applicants will provide photos of the slide secured with screws and photos of the swings that will be secured by cement. Play structures are cushioned by tan bark to cushion a fall. LPAs observed ample amount of shade for children. There are sandboxes for children's use, applicants are reminded to keep sandboxes clean. See 809-C for continuance.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa Domantay	TELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

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: ARBOR PRESCHOOL COLLEGE	FACILITY NUMBER: 013423130
	VISIT DATE: 03/24/2022

NARRATIVE

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Applicants are reminded that if facility plans to provide Incidental Medical Services a plan should be provided. – IMS. A Plan of Operation that includes IMS has been 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.

Kelly Johnston has her site supervisor permit, which expires 2/1/2026 and mandated reported certificate, expires 7/30/2023. Kelly has completed 16 hours of health and safety training including pediatric CPR and First Aid and Lead Poisoning, expires 12/17/23.

Mandated reporter, appeal rights, civil penalties, unusual incident reporting, fingerprint requirements, and COVID protocols were discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and checking Provider Information Notices (PINs). The director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

A license for 34 preschool children will be effective today 3/24/22. An exit interview was conducted, and a copy of the report was provided to applicants Rebecca Lidow and Kelly Johnston.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa Domantay	TELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

LIC809 (FAS) - (06/04)

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