070208034-2-20-2020-52-CC-JPLA-BLYUUL-20200220145344

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070208034
Report Date: 02/20/2020
Date Signed: 02/20/2020 02:53:49 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:	SRVSACCA - KIDS COUNTRY-WALT DISNEY		FACILITY NUMBER:	070208034
ADMINISTRATOR:	HIATT, MOLLY		FACILITY TYPE:	840
ADDRESS:	3250 PINE VALLEY ROAD		TELEPHONE:	(925) 552-4489
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94583
CAPACITY:	120	CENSUS: 29	DATE:	02/20/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Molly Hiatt		TIME COMPLETED:	03:10 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	Licensing Program Analysts (LPAs) Julia Placencia and James Sampair arrived unannounced at 12:30pm for a Required 1-Year inspection, and met director Molly Hiatt. Present were 29 children and an additional 7 staff members. The facility was toured for a health and safety inspection. Hours of operation are Monday through Friday, 7:00am to 6:30pm. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children were inaccessible during the visit. The toilets and sinks were in operable condition. The floors are free of tripping hazards. The kitchen/food preparation and storage areas appear to be clean and free of evidence of rodents and food is protected against contamination. All storage containers for solid waste have tight-fitting covers that are in good repair. Drinking water is available both indoors and outdoors. Menus are posted and visible for parents to review. There are no pools or similar bodies of water at this facility. Outdoor activity space and playground equipment observed to be safe and free of hazards. Climbing equipment is properly anchored to the ground with adequate and appropriate cushioning material to absorb falls. There is a shaded area provided for the children. Required licensing documents were posted. Fire extinguishers, carbon monoxide and smoke detectors meet State Fire Marshall standards. Fire/disaster drills are conducted at least every six months and the last drill was conducted 1/27/20. The facility is operating within its licensed capacity. The facility is within ratio today with 1 teacher supervising no more than 14 children. LPAs did not observe any child left without visual supervision or unattended during the inspection. A physical census was taken of all children present and crossed referenced with the sign in and out sheets. At 1:30pm, a sample of children's files records were reviewed and contain all required licensing documents. Staff records reviewed contain required licensing documents, immunizations and mandated reporter training. Teachers present today meet the qualification requirements. LPAs verified both opening and closing staff have current CPR/First aid training. ***Continued on LIC 809C...

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020

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: SRVSACCA - KIDS COUNTRY-WALT DISNEY	FACILITY NUMBER: 070208034
	VISIT DATE: 02/20/2020

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Individual Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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

The Director is reminded that ALL Staff must be fingerprint cleared 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 encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

There were no deficiencies cited during today’s inspection.

This report must remain on file for 3 years. A Notice of Site Visit was provided and must remain posted for 30 days. Exit interview conducted with Molly Hiatt and copy of report provided.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020

LIC809 (FAS) - (06/04)

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