070209433-1-9-2020-02-CC-PPEN-BKNRQH-20200109121333

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070209433
Report Date: 01/09/2020
Date Signed: 01/09/2020 12:13:39 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:	ST. DAVID'S SCHOOL PRE-KINDERGARTEN		FACILITY NUMBER:	070209433
ADMINISTRATOR:	BUCKINGHAM, DIANA		FACILITY TYPE:	850
ADDRESS:	5613 GARVIN AVENUE		TELEPHONE:	(510) 232-1736
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94805
CAPACITY:	36	CENSUS: 23	DATE:	01/09/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Diana Buckingham		TIME COMPLETED:	12:15 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	Licensing Program Analysts (LPA) Paul Petersen and Jaime Vado conducted an unannounced random annual site inspection for this facility at 0920. At arrival, LPAs met director, Diana Buckingham, who was present along with 22 preschool age children and one teaching staff. One additional teaching staff and one additional child in care arrived while LPA was still present. All adults are background cleared and associated to this facility. The facility is within ratio and capacity. This program operates out of three classrooms located in one building on the grounds of St. David's School. The classrooms and storage cubby area as well as the preschool bathrooms were inspected for health and safety. Furnishings, equipment and play items are age appropriate free of observed hazardous conditions. Surfaces, including floors and countertops, are free of toxins. Hazardous items/cleaning supplies are stored inaccessible to children in care. Toilets and faucets are in good repair. Children's napping equipment is available with napping blankets stored separate for individual child use and sent home for laundering at least weekly. Per facility staff there are no firearms present or stored on the premises. This facility serves snacks. There is a snack menu posted. Children bring their own lunches from home. Food prep and storage areas were inspected and appear clean and free of pests. There is indoor and outdoor drinking water available for children in care via water cups and an outdoor drinking fountain. There are working fire alarms and working carbon monoxide detectors along with fully charged fire extinguishers. Continued of Page 2***************************************************************************************

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ST. DAVID'S SCHOOL PRE-KINDERGARTEN	FACILITY NUMBER: 070209433
	VISIT DATE: 01/09/2020

NARRATIVE

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This facility provides Incidental Medical Services-IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative records. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information 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 facility's outdoor play area is fully fenced and free of observed hazards. There are no pieces of high climbing equipment or slides present. There are no pools or other bodies of water accessible to children. Outdoor play items are free of sharp/broken pieces.

LPA reviewed the facility, personnel and children's records including sign in/sign out records, children's admissions agreements, parents' rights forms, and staff teaching qualifications and background clearances. A teacher qualification form was completed for one staff during this inspection. All required postings are present. At least one teaching staff present has current CPR/First Aid certification.

Facility Staff are encouraged to visit www.ccld.ca.gov for licensing updates and forms. Contact: ChildCareAdvocatesprogram@dss.ca.gov to sign up for quarterly updates. Staff are also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

There were no deficiencies cited during this inspection. A copy of the appeal rights was provided and a notice of site visit was printed and is to be posted for 30 days. A copy of this report is to remain in the facility records for a period of three years from today's date.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020

LIC809 (FAS) - (06/04)

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