073401122-11-1-2021-02-CC-MMAR-C8CUKA-20211101153849

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073401122
Report Date: 11/01/2021
Date Signed: 11/01/2021 03:38:54 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:	WALNUT HEIGHTS KID'S CLUB INC.		FACILITY NUMBER:	073401122
ADMINISTRATOR:	KNIGHT, RYAN		FACILITY TYPE:	840
ADDRESS:	4064 WALNUT BOULEVARD		TELEPHONE:	(925) 930-8458
CITY:	WALNUT CREEK	STATE: CA	ZIP CODE:	94596
CAPACITY:	150	CENSUS: 27	DATE:	11/01/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Ryan Knight		TIME COMPLETED:	04:00 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 1/1/21 at 2:00 pm Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Annual inspection of Walnut Heights Kids Club Inc. LPA met with Director Ryan Knight and explained the purpose of today's inspection. Facility's operating days and hours are Monday to Friday 12:55 - 6 pm in 2 Portables in the premises of Walnut Heights Elementary School. At 2:15 pm The physical plant was inspected. Indoor space: The portables, restrooms and office area were inspected. Facility was observed to be in compliance with teacher to children ratio requirement during LPAs' inspection. Children were engaged in various activities under the visual supervision of the teachers. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. 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. Trash cans for solid waste had tight-fitting covers on and were in good repair. LPA observed a Fire extinguisher, Smoke and Carbon Monoxide Detectors. Log shows that the last Fire Drill was conducted on 7/21. Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles. Facility’s License, Parents’ Rights Poster PUB393, Personal Rights were observed to be posted. 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. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. Shade is provided and there were no bodies of water observed. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2021

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: WALNUT HEIGHTS KID'S CLUB INC.	FACILITY NUMBER: 073401122
	VISIT DATE: 11/01/2021

NARRATIVE

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File Review: Children sign in and out procedures and logs were reviewed. A sampling of Children's and Staff files was taken for review. All child and staff files contained required documents. There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection. Children's Roster was reviewed, and a copy obtained.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

In the areas that were evaluated, no regulatory violations were observed.

At 3:30 pm Exit interview conducted and report was reviewed with the Director, Ryan Knight. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2021

LIC809 (FAS) - (06/04)

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