070209978-7-10-2019-02-CC-GRED-BDXQK4-20190710121344

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070209978
Report Date: 07/10/2019
Date Signed: 07/10/2019 12:13:59 PM

COMPREHENSIVE INSPECTION

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:	PIXIE PLAY SCHOOL		FACILITY NUMBER:	070209978
ADMINISTRATOR:	JESSICA MUSANTE		FACILITY TYPE:	850
ADDRESS:	1797 AYERS ROAD		TELEPHONE:	(925) 689-4030
CITY:	CONCORD	STATE: CA	ZIP CODE:	94521
CAPACITY:	30	CENSUS:	DATE:	07/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:			TIME COMPLETED:	12:20 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 Analyst (LPA) Redmond, arrived at the facility on 07/10/2019 at 9:45 AM, to conduct a health and safety inspection. The purpose of the inspection is to ensure the facility is in compliance with Title 22, CCR and Health and Safety Code Statutes for Child Care Centers. During the inspection, LPA met with Jessica Musante, Director. LPA inspected all areas of the facility accessible to children. During the inspection the LPA made the following observations: The Child Care Center site is licensed for children between the ages of 2 years old to first grade. Capacity/Staffing: The facility is licensed for a capacity of thirty (30) children and is a parent Co-Op. On this date there are twelve (12) children in care, three parents (3) and the Director. The facility is operating at a ratio of 4:12 and is in compliance with capacity limitations, child ratios and staffing levels. The following documents were posted as required: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist. If You See Something, Say Something is not posted on this date an advisory is given. Parents use a daily sign in sheet to sign in their children, which is posted and has all children signed in. Classroom: Furniture and equipment age appropriate and in good repair. Adequate heating, lighting and ventilation. There is separate storage for children’s belongings. The center operates part time only, therefore cots are not available to each child. The facility provides food for the children, however, the school is currently operating at a part time schedule and parents provide some food from home. Restroom: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use. CONTINUED ON LIC809 C

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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: PIXIE PLAY SCHOOL	FACILITY NUMBER: 070209978
	VISIT DATE: 07/10/2019

NARRATIVE

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There are no cleaning solutions, toxins or other hazardous items accessible to children on this date.

Play yard: Enclosed with yard. Climbing structures, swings, slides and other large play equipment, which, is securely anchored and free from hazards. There is a shaded area. Playground is free of debris and other hazards. Drinking water readily available.

No pools, hot tubs. However, there is a water play device and LPA observed children being supervised while participating in the activity.

Emergency Preparedness/Safety: LPA observed a combination smoke and carbon monoxide detector, which, LPA tested and found operable on this date. There is a fire extinguisher, with a classification of 3A 40 B C, which meets fire marshal requirements and last inspected by an outside company on 04/29/19. First aid supplies available. Emergency Disaster Plan is dated current, per the Director. Fire and earthquake drills were last conducted on 04/29/19 and meet six (6) month requirement. The facility utilizes a land line. The facility is not currently providing *Incidental Medical Services (IMS) for any of the children in care and the director is aware of IMS requirements.

Training/Record Review:
Director has current CPR/First Aid training, which expires on 05/2020. Director has completed Mandated Reporter training on 05/05/2018 and there is a certification on file.

Staff Immunization: Directors has immunization records on file including tuberculosis.

Exit interview conducted. This Facility Evaluation Report discussed with the Licensee and signature obtained below. Notice of site visit was issued and shall be posted remain posted for 30 days. Failure to keep this notice posted for the 30 consecutive days will result in an immediate $100 civil penalty. A copy of this report shall be maintained for 3 years and available for public review upon request. Additional reminders and resources provided on next page. – CONTINUED ON LIC 809C

FACILITY IN SUBSTANTIAL COMPLIANCE. NO DEFICIENCIES CITED ON THIS DATE.

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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: PIXIE PLAY SCHOOL	FACILITY NUMBER: 070209978
	VISIT DATE: 07/10/2019

NARRATIVE

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REMINDERS/RESOURCES

· CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov

· Licensees may register to receive child care updates: childcareadvocatesprogram@dss.ca.gov

· Resource and Referral Agencies: https://www.ccrcca.org/resources/family-resource-directory/item/california-child-care-resource-referral-network

· The childcareadvocatesprogram@dss.ca.gov is the email address for the applicant to sign up to receive PINS.

· Criminal Background Clearance: All assistants, volunteers, frequent adult visitors, adults living in the home (adults are individuals 18 years of age or older) must be fingerprint cleared and associated to the facility prior to be in the presence of children in care. Failure to comply, requires an immediate civil penalty of $100 to $3000 per person, per incident

· CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

· NEW LAW: Safe Sleep Regulations: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

· Licensees and all staff are Mandated Reporters and are required to report to CCLD suspected child abuse. Online training can be found at: www.mandatedreporterca.com.

· Licensee shall be present in the home and shall ensure children in care are supervised at all times. When temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise children in Licensee’s absence. Children shall not be left in parked vehicles.

· *LPA discussed IMS services and the requirement to update the plan of operation. Specifics on the plan can be found in the child care center evaluator manual (CCC EM) Policy 101173. 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. Americans with Disabilities Act (ADA)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.

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

LIC809 (FAS) - (06/04)

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