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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700515
Report Date: 07/15/2022
Date Signed: 07/15/2022 01:46:33 PM

Document Has Been Signed on 07/15/2022 01:46 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:BUILDING KIDZ OF LIVERMOREFACILITY NUMBER:
015700515
ADMINISTRATOR:MISTRY, DEVALFACILITY TYPE:
830
ADDRESS:3820 EAST AVENUETELEPHONE:
(408) 718-2970
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 5DATE:
07/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Deval MistryTIME COMPLETED:
01:55 PM
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On July 15, 2022 at approximately 8:05 am Licensing Program Analyst (LPA) Simerjit Kaur arrived at the facility to conduct an unannounced required 1 year annual inspection. LPA met with Facility Director Deval Mistry and toured the facility to conduct a Health and Safety Inspection. Present during the inspection are 5 infant age children and 4 staff members. Hours of operation are Monday through Friday, 7:30am to 5:30pm.

This program operates out of the Zinnia and Aster classrooms. LPA observed the cleanliness of floors and surfaces, working carbon monoxide detector, and fully charged fire extinguisher 2A10BC, which is accessible throughout the facility. Smoke detectors/alarms meet the State Fire Marshall standards. Required licensing documents were posted. The classroom was inspected for age appropriate furnishings, equipment, and adequate storage for children’s belongings. The classroom has cribs for infants, the diaper changing counter is within arms reach of a sink and fully stocked with supplies. The isolation area is director's office and lobby. Outdoor activity space and playground equipment observed to be safe and free of hazards. There are no pools or similar bodies of water at this facility. Cleaning supplies/toxins are stored inaccessible to children. The facility serves breakfast, lunch and snacks. The menu is posted lobby and copy provided to parents. LPA reviewed storage of food, medication, which is inaccessible to the children. Per director, there are no firearms present on the premises.

A copy of the children’s roster was obtained. LPA reviewed children files and staff members files. LPA also reviewed Individual Infant Sleep Plan and Sleep log. All staff members are fingerprint cleared, completed current Mandated Reporter training and proof of immunization. Sign in/out logs are maintained. LPA verified both opening and closing staff have current CPR/First aid training, CPR/First Aid certificates expires on 9/2023.

Continued on LIC 809-C

Jason Jang
Simerjit Kaur
DATE: 07/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2022
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: BUILDING KIDZ OF LIVERMORE
FACILITY NUMBER: 015700515
VISIT DATE: 07/15/2022
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The center also conducts and documents fire and earthquake drills once every 6 months and the logs show that drills were conducted on 5/26/2022. The director was reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed facility.

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 distribution list.

Facility Director 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.

LPA also informed facility director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.


To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.
There are no deficiencies cited today. 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 with Director Deval Mistry.
SUPERVISOR'S NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2022
LIC809 (FAS) - (06/04)
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