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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070211735
Report Date: 08/18/2023
Date Signed: 08/18/2023 02:40:03 PM


Document Has Been Signed on 08/18/2023 02:40 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:ACORN LEARNING CENTER OF SAN RAMONFACILITY NUMBER:
070211735
ADMINISTRATOR:SHIELDS, KARENFACILITY TYPE:
850
ADDRESS:5075 CROW CANYON ROADTELEPHONE:
(925) 735-7900
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY:151CENSUS: 37DATE:
08/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Carolyn GarzaTIME COMPLETED:
02:50 PM
NARRATIVE
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On August 18, 2023 at 1:30pm, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced for a case management inspection. LPA met with director Carolyn Garza. Present were 37 children and an additional 6 staff members.

The purpose of today’s visit was to follow up on an unusual incident report received in the licensing office on 8/9/23. It was reported that during recess on 8/8/23, a child (C1) left the playground alone without staff’s knowledge by opening the side gate to the parking lot. A stranger passing by the facility found C1 and brought C1 to the front door of facility.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC 9224). The LIC 9224 must be placed in each child's file to be reviewed by licensing.



See LIC809D for deficiencies cited during today's inspection. Failure to correct will result in a $100 per day civil penalty until corrected.

This is a Zero Tolerance violation. An immediate $500 civil penalty is assessed today and $100 per day will be assessed until corrected. LIC 421M was provided. Subsequent Zero Tolerance violations may result in $1000 immediate civil penalty and $100 per day until corrected.


Exit interview conducted with director Carolyn Garza and copy of report provided. Notice of Site visit provided and must be posted for 30 days.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:
DATE: 08/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/18/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 08/18/2023 02:40 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612


FACILITY NAME: ACORN LEARNING CENTER OF SAN RAMON
FACILITY NUMBER: 070211735

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/21/2023
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision -
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time...
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POC: By 8/21/23, director shall submit a written plan of action detailing the steps staff will take to ensure children are supervised at all times. **This is a Zero Tolerance violation. An immediate $500 civil penalty is assessed today and $100 per day will be assessed until corrected.
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...Supervision shall include visual observation

This requirement is not met as evidenced by: Based on interview conducted, C1 exited the playground alone without staff’s knowledge, which is an immediate health and safety risk to children in care.
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***Subsequent Zero Tolerance violations may result in $1000 immediate civil penalty and $100 per day until corrected.

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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: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:
DATE: 08/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/18/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2