073400419-12-3-2019-02-CC-PPEN-BJHTUK-20191203140229

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073400419
Report Date: 12/03/2019
Date Signed: 12/03/2019 02:02:36 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:	WCCUSD - MONTALVIN C/O PRESCHOOL DEPARTMENT		FACILITY NUMBER:	073400419
ADMINISTRATOR:	ROMERO, VENESSA		FACILITY TYPE:	850
ADDRESS:	300 CHRISTINE DRIVE		TELEPHONE:	(510) 231-1405
CITY:	SAN PABLO	STATE: CA	ZIP CODE:	94806
CAPACITY:	24	CENSUS: 20	DATE:	12/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:	Vanessa Romero		TIME COMPLETED:	02:05 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) Paul Petersen conducted an unannounced random annual site inspection for this facility at 1225. Present at the time of LPA's arrival were head teacher, Vanessa Romero, and three additional teaching staff along with 20 preschool age children in care. Two of the staff present are qualified teachers and two are aides. The facility is within ratio and capacity. All teaching staff present are background cleared per West Contra Costa Unified School District (WCCUSD). This program operates out of one classroom (Portable Room 125) on the grounds of WCCUSD Montalvin School. Furnishings and equipment are age appropriate and in good repair. There are no toxins or hazardous items observed to be accessible to children in care. Floors and surfaces, including counter tops, are free of toxins and hazardous conditions. There is available heating and ventilation for temperature management. The building and grounds of this facility are maintained by WCCUSD including daily janitorial service. There is a fully charged fire extinguisher and working carbon monoxide detector present. There is a centralized smoke/fire alarm system. First aid supplies were inventoried. This facility provides lunch for the AM and PM class and there is a menu posted for review. Lunches are prepared at the WCCUSD kitchen. Drinking water is observed to be available for children in care both indoors and out via working water fountain and water pitcher with cups. Sinks and toilets are age appropriate and in good repair. Continued on Page 2*************************************************************************************

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

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: WCCUSD - MONTALVIN C/O PRESCHOOL DEPARTMENT	FACILITY NUMBER: 073400419
	VISIT DATE: 12/03/2019

NARRATIVE

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The play ground/outdoor area is fully enclosed/fenced and designated for preschool use only. There is a waiver on file for lack of shade in the outdoor area. There are no high climbing equipment or swings in the preschool play area. Play items appear free of broken/sharp pieces. There are no observed hazardous conditions and no accessible bodies of water are present.

LPA reviewed the facility, personnel and children's records including children's health screenings, immunization records, and parents' rights forms, staff teaching qualifications and staff background clearances. All required postings are present. The head teacher and two other staff present have current CPR/First Aid certification.

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

Licensee is encouraged to visit www.ccld.ca.gov for licensing updates and forms. Contact: ChildCareAdvocatesprogram@dss.ca.gov to sign up for quarterly updates. The director is 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 notice of site visit was provided and is to remain posted for 30 days. A copy of the appeal rights and a copy of this report were provided and this report is to remain in the facility records for a period of three years.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2