070213231-6-9-2021-02-CC-MMAR-C3TQZH-20210609123645

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070213231
Report Date: 06/09/2021
Date Signed: 06/09/2021 12:36:52 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:	MURWOOD KEYSPOT		FACILITY NUMBER:	070213231
ADMINISTRATOR:	GARNET HERNDON-SHAH		FACILITY TYPE:	840
ADDRESS:	2050 VANDERSLICE AVENUE		TELEPHONE:	(925) 932-8118
CITY:	WALNUT CREEK	STATE: CA	ZIP CODE:	94596
CAPACITY:	120	CENSUS: 44	DATE:	06/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Melissa Sheridan (Muller)		TIME COMPLETED:	12:30 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	On 6/9/21 at 10:30 AM Licensing Program Analyst (LPAs) Monica Mathur and Michelle Sutton conducted an unannounced Annual inspection of Murwood Keyspot (school age program). LPA met with Director, Melissa Sheridan (Muller) and explained the purpose of today's inspection. Facility is located in the premises of Murwood Elementary School. LPAs were granted the inspection authority to enter the facility. Facility's normal operating days and hours are Monday to Friday 7:00 AM to 6:00 PM. Operational hours changed during COVID from 7:30 AM - 5:30 PM allowing 30 minutes on each side for clean up, disinfecting chores. At 10:35 AM The physical plant was inspected. LPA toured the premises with the Director. Indoor space: Facility operates in 2 portable rooms during this inspection. There were 44 children with 8 staff present during the inspection. Facility was observed to be in compliance with school age ratio requirements. The classrooms, restrooms, food storage areas and spaces accessible to children were inspected. Disinfectants, cleaning solutions, poisons and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Storage areas for poisons were locked and medications were kept in a safe place inaccessible to children. Cabinets, drawers, and rooms used for storage were locked. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. Foods and beverages were stored safely. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. Director stated that facility does not possess nor store any weapons on the premises. LPA observed a working Fire extinguisher, Smoke and Carbon Monoxide Detectors.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021

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: MURWOOD KEYSPOT	FACILITY NUMBER: 070213231
	VISIT DATE: 06/09/2021

NARRATIVE

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All toilets, hand washing areas were observed to be in safe and sanitary operating condition. All materials and surfaces accessible to children appeared to be toxic free. Menus were observed to be posted at least 1 week in advance in a place visible by the child’s authorized representative, dated and kept on file for 30 days and made available upon request.

At 11:00 AM Outdoor Space: Outdoor playground was inspected and observed to be fenced and safe. The play equipment was maintained in good condition and free of hazards. Surface of the outdoor activity space was in safe condition and free of hazards. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were no bodies of water observed. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

At 11:15 AM File Review: Children sign in and out procedures and logs were reviewed. All children were signed in and in compliance with the school age sign in/out procedures. A sample of 10 Children's files and eight (8) Staff files was taken for review.
Child files contained LIC700 Information and Emergency Forms and Medical Assessments – Staff files contained their Personnel Record LIC501 with Health Screening LIC503, Immunizations for Measles, Pertussis and Influenza or opt out statement and current Mandated Reporter Training per AB1207. There was at least one staff present with current certification in Pediatric CPR and First Aid at the facility during inspection. Children's Roster LIC9040 and Personnel Report LIC500 was reviewed, and a copy obtained. Director Melissa stated she took over responsibility as Director of the facility 1 week ago. She will submit her Director Qualifications packet within 30 days. LPA reviewed her file and she has all required documents to be Director qualified.

Director was reminded about ensuring that each child is accorded their personal rights. LPA informed Director that the Department shall notify the licensee to immediately terminate the employment of or to remove/bar any person with specified convictions or for other reasons. The licensee shall comply with the notice. LPA reminded Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $3000.00 per person.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021

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: MURWOOD KEYSPOT	FACILITY NUMBER: 070213231
	VISIT DATE: 06/09/2021

NARRATIVE

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LPA reminded Director about violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

Website for Quarterly Updates:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

At 12:15 PM In the areas that were evaluated, no regulatory violations were observed. Exit Interview was conducted with Director, where this report was reviewed and discussed. Report was signed by the Director confirming receipt of documents.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021

LIC809 (FAS) - (06/04)

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