073400475-4-25-2024-02-CC-ACUY-D4NU6K-20240425151827

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073400475
Report Date: 04/25/2024
Date Signed: 04/25/2024 03:18:35 PM

Document Has Been Signed on 04/25/2024 03:18 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	OLD FIREHOUSE SCHOOL		FACILITY NUMBER:	073400475
ADMINISTRATOR:	ALEXANDRA DUTTON		FACILITY TYPE:	830
ADDRESS:	984 MORAGA ROAD		TELEPHONE:	(925) 284-4321
CITY:	LAFAYETTE	STATE: CA	ZIP CODE:	94549
CAPACITY:	8	CENSUS: 7	DATE:	04/25/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Alexandra (Alex) Dutton		TIME COMPLETED:	03:30 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 04/25/2024 at 9:00 AM Licensing Program Analyst (LPA), A. Curry conducted an unannounced required inspection. LPA met with Designated Director, Alex Dutton, to explain the purpose of today's visit. This is an infant program licensed for 8 children. This facility operates Monday – Friday from 8:00AM – 5:30 PM. Per the director there are 8 infants enrolled. LPA A. Curry began facility tour with Director. All areas identified on the facility sketch were inspected. Upon arrival, LPA observed 7 infants with 2 Staff. Teacher-infant ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times. The facility was inspected to ensure that it is clean, safe, sanitary, and in good repair to ensure the safety and well being of children, employees and staff. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. The facility has age appropriate furniture and equipment including but not limited to cribs, cots/mats and changing tables. LPA observed sufficient infant napping equipment that meets the requirements of Title 22 regulations. LPA did not observe any baby walkers or any items that fall into that category present in the facility. At this time, the office is used as an isolation area. Parents are contacted immediately when children are determined to be ill. Snack menus were reviewed. The facility provides snack and meals are provided by the children's authorized representatives. LPA observed that bottles/cups, dishes, and containers of food brought by the infant’s authorized representatives are labeled with the infant’s name and current date. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to infants. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Ashley Curry	TELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: OLD FIREHOUSE SCHOOL	FACILITY NUMBER: 073400475
	VISIT DATE: 04/25/2024

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
26
27
28
29
30
31
32

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. LPA did not observe any bodies of water during this visit.

Sign in and out sheets were reviewed. Staff Records were reviewed to ensure that personnel records are maintained on all staff. Also to ensure that Teacher’s present have required infant units on file and are qualified. Children’s Records were reviewed to ensure that each child has a separate, complete, and current record, a Needs and Services Plan, and a medical assessment are on file. LPA issued the Children’s Record Review (LIC 857) and the Review of Staff records (LIC 859) to the director during this inspection. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:
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 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Ashley Curry	TELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: OLD FIREHOUSE SCHOOL	FACILITY NUMBER: 073400475
	VISIT DATE: 04/25/2024

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
26
27
28
29
30
31
32

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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-care-centers/. PIN 22-05-CCP

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. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted, appeal rights were given, and report was reviewed with the Director, Alex Dutton.

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.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Ashley Curry	TELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4