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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070209834
Report Date: 01/29/2024
Date Signed: 01/29/2024 05:29:18 PM


Document Has Been Signed on 01/29/2024 05:29 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, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:NOMURA PRESCHOOLFACILITY NUMBER:
070209834
ADMINISTRATOR:HERNANDEZ, KEIKOFACILITY TYPE:
850
ADDRESS:1711 CARLSON BOULEVARDTELEPHONE:
(510) 526-7847
CITY:RICHMONDSTATE: CAZIP CODE:
94804
CAPACITY:125CENSUS: 45DATE:
01/29/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Keiko Hernandez & Matthew ClarkTIME COMPLETED:
05:40 PM
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On 1/29/24 at 10:45am, Licensing Program Manager (LPM) Loretta Dyson and Licensing Program Analyst (LPA) Brittany Crass arrived at the facility for an unannounced required inspection. LPM and LPA initially met with Keiko Hernandez, the director, and then with Matthew Clark, the administrator, who arrived shortly after the inspection began. There were 45 children, and 9 additional staff also present. This program currently operates in 4 classrooms: Roosters, Kiwis, Pelicans and Chickies, Monday-Friday 7:30am-6pm.

LPM and LPA conducted a tour of each of the classrooms, all children's bathrooms, kitchen area, and playground to conduct a health and safety inspection. The floors and surfaces in each classroom appear to be safe and in good repair. There is an ample supply of age appropriate furniture, toys, activities and equipment which appear to be in good condition. There is adequate storage for children's belongings. The facility has mats for children to nap on, and LPM and LPA observed that they are stored appropriately. The bathrooms are clean, and the toilets and sinks are in good repair. There is a sufficient number of toilets and sinks available for the number of children enrolled. There is a separate bathroom available for staff. The isolation area is in a classroom that is not currently being used for the care of children, and the bathroom in this classroom is used for isolation. Meals are brought from home, and the center serves snacks. There is a snack menu posted, which was observed to be dated at least a week in advance. There are individual water bottles available for children, and staff refill them as needed. LPM observed that all containers used for storage of solid waste are in good repair and have a tight fitting cover that is kept on. LPM did not observe any bodies of water, hazardous items, toxins or medication accessible to children today. All required forms are posted. The last documented fire and earthquake drills were conducted on 11/7/23 and 11/14/23, respectively. The center is equipped with first aid supplies, a working telephone, working fire alarm system (last tested in January 2024), pull down fire alarm, working carbon monoxide detectors and fully charged 3A40BC fire extinguishers.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: 510-695-0243
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024
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: NOMURA PRESCHOOL
FACILITY NUMBER: 070209834
VISIT DATE: 01/29/2024
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The outdoor playground is fully fenced. There is sufficient cushioning underneath the play structure to absorb a fall, and the structure is secure and age appropriate. There is an ample supply of shade and the sand box was observed to be free of debris. There is a fenced garden on the yard. The facility keeps medication stored in a cabinet that is out of reach of children, and LPM and LPA observed that the medication is labeled for each individual child.

At 1pm, LPM Dyson verified that one staff member who is present today, and observed to be providing care to children in the classroom, has a pending criminal record clearance. Upon review of documentation that the facility received, it was noted that the wrong employee type was entered at the livescan. The facility believed that the notification was indicating that the staff had a clearance. This staff member is not needed to maintain ratio. This staff member was not left alone with children in the classroom.

At 1:15pm, staff and children's records were reviewed. All children's files are complete with the required documents. All staff files reviewed are complete with the required documents, and LPM was able to verify qualifications. At least one staff member that opens and closes the center has current CPR/First Aid certificates. The director verified that all children are signed in on the Bright Wheel application, and the center has a back up plan if the application does not work. The facility is in compliance with the sign in/out procedures.

Licensee 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.

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 21-21.1CCP). LPM verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. There was no lead exceedance found for any outlets tested.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: 510-695-0243
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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: NOMURA PRESCHOOL
FACILITY NUMBER: 070209834
VISIT DATE: 01/29/2024
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Licensee 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 provides Incidental Medical Services – IMS. LPM reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: 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-carecenters/.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

A Notice of Site Visit was given and must remain posted for 30 days. Appeal Rights were provided. See LIC 809D for deficiency being cited today.

An exit interview was conducted and report was reviewed with Matthew Clark, the administrator.

SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: 510-695-0243
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 01/29/2024 05:29 PM - It Cannot Be Edited

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: NOMURA PRESCHOOL
FACILITY NUMBER: 070209834

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101170(e)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above as a staff member, who has a pending criminal record clearance, was observed caring for children in a classroom with other staff. The staff member was fingerprinted but an error occurred. The facility believed the staff member had a clearance based on documentation they received. This poses a potential risk to the health and safety of children in care.
POC Due Date: 02/29/2024
Plan of Correction
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Upon notification of this deficiency, the facility immediately pulled the staff member from the classroom and informed them that they cannot return to work at the facility until the criminal record clearance is obtained. The facility will provide proof of the criminal record clearance by 2/29/24.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: 510-695-0243
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024
LIC809 (FAS) - (06/04)
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