073402672-5-15-2019-52-CC-CACA-BC7U3X-20190515151417

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073402672
Report Date: 05/15/2019
Date Signed: 05/15/2019 03:14:22 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SRVSACCA - KIDS' COUNTRY AT COYOTE CREEK SCHOOL		FACILITY NUMBER:	073402672
ADMINISTRATOR:	CASEY WATSON		FACILITY TYPE:	840
ADDRESS:	8700 NORTH GALE RIDGE ROAD		TELEPHONE:	(925) 552-4485
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94582
CAPACITY:	170	CENSUS: 38	DATE:	05/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Mary Kay Moriarty		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	Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced Annual/Random inspection. There were 10 staff and 38 children present during the inspection. Furniture and equipment was observed to be in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children were inaccessible during the visit. The toilets and sinks were in operable condition. The floors were free of tripping hazards. The kitchen/food preparation and storage areas were observed to be clean and free of evidence of rodents. Food is protected against contamination. All storage containers for solid waste have tight-fitting covers that are in good repair. Drinking water is available both indoors and outdoors. Menus are posted and visible for parents to review. There are no pools or similar bodies of water at this facility. Outdoor activity space and playground equipment was observed to be safe and free of hazards. The facility is operating within its licensed capacity. The facility is within ratio today with one teacher supervising no more than 14 children. LPA did not observe any child left without visual supervision or unattended during the inspection. LPA verified both opening and closing staff have current CPR/First aid training. The director understands that prior to working or volunteering in a licensed child care facility, all individuals subject to criminal record review shall obtain a clearance or criminal record exemption. A sample of children’s records were reviewed. Files reviewed contained emergency information. Staff records reviewed have required health screening and immunization, Fire/Disaster drill are conducted at least once every six months.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 856-6376
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: SRVSACCA - KIDS' COUNTRY AT COYOTE CREEK SCHOOL	FACILITY NUMBER: 073402672
	VISIT DATE: 05/15/2019

NARRATIVE

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The facility has updated the plan of operation to include incidental medical services.

Mary Kay Moriarty's file was reviewed during the inspection for required director qualification.

The director was encouraged to email ChildCareAdvocatesProgram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

There were no deficiencies cited during today’s inspection.

Exit interview conducted with Mary Kay Moriarty.

Director was provided a copy of the appeal rights.

Notice of Site visit was provided at the time of inspection, and must be posted for 30 days.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 856-6376
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019

LIC809 (FAS) - (06/04)

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