070200431-4-11-2025-02-CC-ILOA-DFLV56-20250410160724

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070200431
Report Date: 04/10/2025
Date Signed: 04/11/2025 08:50:37 AM

Document Has Been Signed on 04/11/2025 08:50 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:	KENSINGTON NURSERY SCHOOL		FACILITY NUMBER:	070200431
ADMINISTRATOR/ DIRECTOR:	MARDIANN KANEKO		FACILITY TYPE:	850
ADDRESS:	52 ARLINGTON AVENUE		TELEPHONE:	(510) 524-7963
CITY:	KENSINGTON	STATE: CA	ZIP CODE:	94707
CAPACITY: 38	TOTAL ENROLLED CHILDREN: 33	CENSUS: 15	DATE:	04/10/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:36 PM
MET WITH:	Mardiann Kaneko		TIME VISIT/ INSPECTION COMPLETED:	04:23 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	On April 10, 2025 Licensing Program Analyst (LPA) Indira Loza met with Director Mardiann Kaneko for an unannounced Annual/Random inspection. Present during today's inspection were 15 preschoolers and 5 staff. The teacher/child ratio was being met today. The center was toured for a health and safety check. This center operates Monday through Friday 7:30am to 6pm. CLASSROOMS: The school operates out of three classrooms. There is adequate heating/air conditioning, ventilation, and lighting. There were no cleaning supplies or toxic items accessible to children. The toys appear to be safe and well maintained. There were play and learning materials available for the children and each classroom had plenty of age appropriate activities. The furniture and equipment are age appropriate and in good repair. There is proper individual storage space for each child. The center is equipped with smoke and carbon monoxide detectors, telephone, and pull down fire alarm system - all were in working order. There are multiple fully charged 3A40BC fire extinguishers throughout the facility. FOOD SERVICE AREAS: All food is brought from home. Water is provided to the children from the tap located in the kitchen. The children bring their own water bottles from home and they are refilled at school when needed. OUTDOOR PLAY AREAS: The facility utilizes two play yards for outdoor play. One play yard is shared with another facility that is located on the premises (facility #073409602). The shared yard is on the lower level of the property. Both yards are fully fenced in and has plenty of age appropriate activities and shade for the children in care. There is space for the children to run and develop their gross motor skills. There are no bodies of water or pools on the daycare premises. The play yard is free of hazards, such as holes, broken glass, and other debris. The play structures were anchored and had cushioning material underneath to absorb any falls.

Mayla Mendoza	TELEPHONE: (510) 292-9724
Indira Loza	TELEPHONE: 510-368-3672
	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: KENSINGTON NURSERY SCHOOL	FACILITY NUMBER: 070200431
	VISIT DATE: 04/10/2025

NARRATIVE

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BATHROOMS: The center has separate bathrooms designated for staff and children. The children restrooms are appropriately sized for the children, and all are in safe, sanitary, and operating condition.

RECORDS: LPA reviewed 5 children files and 5 staff files. All files reviewed were complete. All individuals subject to criminal record review have a criminal record clearance. All required documents are posted for public review. There are multiple staff members with current CPR certification during all hours of the day, the staff's CPR certificates expire 8/8/25. A physical census of the children was taken and cross referenced with the sign-in and out log. All children were accounted for and properly signed in. The center is up to date with the disaster drills - the last drill was conducted on 1/6/25.

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities 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 form (LIC 624). Incidents must be reported within 24 hours by phone or fax. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed 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.

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/inspection-process.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

This facility is provides Incidental Medical Services (IMS), but there are no children who require IMS. For IMS information see PIN 22-02-CCP The following information regarding ADA was provided:

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

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: KENSINGTON NURSERY SCHOOL	FACILITY NUMBER: 070200431
	VISIT DATE: 04/10/2025

NARRATIVE

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US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
CCC COMPLETED TESTING AND NO EXCEEDANCES WERE FOUND. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

There were no citations issued during today's visit.

Exit interview conducted.
Report reviewed with Director Mardiann Kaneko.
Notice of Site Visit provided and must remain posted for 30 days.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

LIC809 (FAS) - (06/04)

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