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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700510
Report Date: 09/27/2021
Date Signed: 09/27/2021 01:03:53 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:CHALLENGE SCHOOL PRESCHOOL-FREMONT CAMPUSFACILITY NUMBER:
015700510
ADMINISTRATOR:DUNHAM, KIMBERLYFACILITY TYPE:
850
ADDRESS:41386 FREMONT BLVD.TELEPHONE:
(510) 226-6878
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY:48CENSUS: 14DATE:
09/27/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:47 AM
MET WITH:Kimberly DunhamTIME COMPLETED:
01:07 PM
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Licensing Program Analyst (LPA) Melanie Otsuji conducted an unannounced REQUIRED 1 YEAR INSPECTION on today's date, 9/27/2021. LPA was met by Director, Kimberly Dunham. Present during today's visit were 14 preschool aged children and 4 staff members. A health and safety inspection was conducted inside and outside. Facility days and hours of operation are Monday through Friday 8:00AM - 5:30PM.

LPA reviewed (4) staff records on 9/27/2021 at 10:08AM. (10) Children's files were reviewed. The classrooms and play yard are age appropriate and in good repair. Bathrooms are clean and in working order. The staff have a separate bathroom located within the facility. The sign in and out logs (reviewed electronically via Brightwheel application) were reviewed and checked with current census. Outdoor play areas are free of hazards and provided a shaded area for the children and access to drinking water. There is a working telephone. Working carbon monoxide detector (per director carbon monoxide detector is hard wired with alarm system), smoke detector (per director smoke detector is hard wired with alarm system) and fully charged fire extinguisher were observed at the facility. Opening and closing staff have current CPR and first aid training. LPA observed there are tight fitting lids on trash cans located inside the center. The center documents and conducts fire/disaster drills with the last one documented on 8/12/2021. Due to COVID facility is requesting children bring snack and lunch from home. If the child forgets, staff will call parents to request they drop something off or ask for permission to give back up snack/lunch from the school.
Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

See 809-C for second page of report....

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: CHALLENGE SCHOOL PRESCHOOL-FREMONT CAMPUS
FACILITY NUMBER: 015700510
VISIT DATE: 09/27/2021
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Director is reminded that unusual Incidents must be reported within 24 hours by phone. Written report is to follow within 7 days utilizing form LIC624. LPA informed the Director that all forms can be downloaded at www.ccld.ca.gov and encouraged the Director to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Director was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

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. 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

LPA obtained a current LIC 500 (PERSONNEL ROSTER) and LIC9040 (CHILD CARE FACILITY ROSTER)

An exit interview was conducted with the Director, Kimberly Dunham. No deficiencies are cited on today's date. The Director was provided a copy of their appeal rights and the signature on this form acknowledges receipt of these rights. A Notice of Site visit was posted at the time of inspection and must remain posted for 30 days.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021
LIC809 (FAS) - (06/04)
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