070200593-12-19-2019-02-CC-SNEN-BJZTCQ-20191219133706

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070200593
Report Date: 12/19/2019
Date Signed: 12/19/2019 01:37:12 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	TOPS - THE ORINDA PRESCHOOL(PARENT COOP)		FACILITY NUMBER:	070200593
ADMINISTRATOR:	KRISTIN BURCHAM		FACILITY TYPE:	850
ADDRESS:	10 IRWIN WAY		TELEPHONE:	(925) 254-2551
CITY:	ORINDA	STATE: CA	ZIP CODE:	94563
CAPACITY:	75	CENSUS:	DATE:	12/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Sara Bossenbroek and Kristina Burcham		TIME COMPLETED:	01:45 PM

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An unannounced Annual/Random site visit was conducted by LPA Susan Neeson. Met with Kristina Burcham, Director and Sarah Bossenboek, Administrative Assistant. Visit began at 9:00 AM. There are 38 preschool age children present and 7 staff.

A tour of the facility was conducted. During this visit, ratios were met at all times. Disinfectants, cleaning solutions, poisons and other dangerous items are inaccessible to children. Poisons are locked. Medications are inaccessible to children. All toilets and sinks are operable and sanitary with sufficient soap and paper products. There are adequate toys and equipment for children in care. All equipment is developmentally appropriate and in good condition. Uncontaminated drinking water is available both indoors and outdoors. A sample of children's and staff records were reviewed. Sign-in and out forms were reviewed. The facility has one rabbit as a pet.

The outdoor activity space surface is maintained in a safe condition and is free of hazards today. Playground equipment appears to be in good condition, free of sharp, loose or pointed parts. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is fully fenced. he sign in and sign out was reviewed for legal signatures. .

Program operates 9 to 12 for the regular program and after that is a single room that operates from 12 to 2:30.

Kristina Burcham stated that there are no guns or firearms on the premises.

Licensee is reminded that ALL assistants, volunteers or adults that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov and for day care updates visit www.myccl.ca.gov

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan Neeson	TELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

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: TOPS - THE ORINDA PRESCHOOL(PARENT COOP)	FACILITY NUMBER: 070200593
	VISIT DATE: 12/19/2019

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a 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, available at: http://www.ada.gov/childqanda.htm. Plan of Operation is needed for the file.

The following documents were issued and discussed: blue immunization forms, Flu prevention information, Quarterly update from Department, AB 1207 information, Safe Sleep for infants, Fire/earthquake drill information, Parents Rights and Licensee rights. .

Administrative assistant will be invited to next record keeping orientation.

Copy of roster is requested. Copy of LIC 500 is requested.

No deficiencies are observed.

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan Neeson	TELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

LIC809 (FAS) - (06/04)

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