015700562-6-2-2022-52-CC-MOTI-CEZUX5-20220602155746

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700562
Report Date: 06/02/2022
Date Signed: 06/02/2022 03:58:03 PM

Document Has Been Signed on 06/02/2022 03:58 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:	ABC PRESCHOOL & DAYCARE		FACILITY NUMBER:	015700562
ADMINISTRATOR:	MALHOTRA, ANUPAMA		FACILITY TYPE:	840
ADDRESS:	20135 SAN MIGUEL AVENUE		TELEPHONE:	(408) 839-5669
CITY:	CASTRO VALLEY	STATE: CA	ZIP CODE:	94546
CAPACITY:	20	CENSUS: 0	DATE:	06/02/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	12:05 PM
MET WITH:	Anupama Malhotra		TIME COMPLETED:	04:15 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	A Prelicensing Visit was conducted today 6/2/2022 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met today with Applicant/Director, Anupama Malhotra. The applicant has submitted an application for a school-age license. Also on site is a preschool component. The applicant has submitted an application for a SCHOOL AGE license. A health and safety inspection was conducted inside and outside. The school age program will operate in 2 classrooms normally occupied by preschool children. Also on site is a Preschool component. Operating hours Monday through Friday from 7:00AM - 6:00PM. The measurements of classrooms were taken, yard measurements were already on file from previous application: INDOORS: 873.29 square feet = 25 children OUTDOORS: 7774.96 square feet = 104 children A fire clearance is approved by the Alameda County Fire Department on 5/10/2022. The classrooms are equipped with age appropriate materials and equipment. The yard is fenced in all around and there are climbing structures. Artificial turf and tan bark is used for cushioning. There is shade available for the children in the play yard. There are sinks and toilets available for children and provide privacy. The facility serves AM/PM snacks and lunch. Drinking water is available inside and outside. The center has first aid supplies available. Carbon monoxide is available. The sign in/out sheet allows for parents' full legal signature. The center director, Anupama Malhotra has completed 16 hours of health and safety training including pediatric CPR and First Aid.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022

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: ABC PRESCHOOL & DAYCARE	FACILITY NUMBER: 015700562
	VISIT DATE: 06/02/2022

NARRATIVE

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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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.

Applicants were reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 reviewed with Applicants the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

A license for 20 school aged children operating out of 2 classrooms will be approved effective today's date, 6/2/2022. Capacity of Preschool and School Age Children may vary but never exceed total of 41 children.

An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022

LIC809 (FAS) - (06/04)

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