073403447-9-24-2019-02-CC-RHOE-BGBVDY-20190924162132

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073403447
Report Date: 09/24/2019
Date Signed: 09/24/2019 04:21:39 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:	INDIAN VALLEY KIDS ONLY CLUB, INC.		FACILITY NUMBER:	073403447
ADMINISTRATOR:	LESLIE DALTON		FACILITY TYPE:	840
ADDRESS:	551 MARSHALL DRIVE		TELEPHONE:	(925) 943-7957
CITY:	WALNUT CREEK	STATE: CA	ZIP CODE:	94598
CAPACITY:	120	CENSUS: 62	DATE:	09/24/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:50 PM
MET WITH:	Aiello, Leslie		TIME COMPLETED:	04:45 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	3 LPA, Hollie, met with Center Director, Leslie Aiello, for the purpose of a Random Health and Safety Inspection. Present at the start of the visit was another staff, Mackenzie Crane in the classroom with the Director. Children had not begun to arrive inside of the center. Children and additional staff were in the multi purpose room up 55 with 5 teachers. A tour of the facility was conducted. The opening and closing staff have current CPR/FA. The Director is fully qualified. The person who signs the child in/out uses full legal signatures and records the time of day. Personnel records are maintained on the licensee, administrator and each employee which includes documentation of the educational background, training and or experience specified in this chapter. Each personnel record contains a health screening as specified in section 101216g. Personnel records are maintained on the licensee, administrator and each employ. Per the Director, there are no pools or other bodies of water or Fire arms on the premises of the day care. The Center appears to be clean, safe sanitary and in good repair to ensure the safety and well being of children, employees and visitors. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible to children during this visit. Storage areas for poisons are locked. SEE NEXT PAGE FOR CONTINUED REPORT

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda Hollie	TELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

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: INDIAN VALLEY KIDS ONLY CLUB, INC.	FACILITY NUMBER: 073403447
	VISIT DATE: 09/24/2019

NARRATIVE

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Furniture and equipment appears to be in good condition, free of sharp, loose or pointed parts Toilets and hand-washing. facilities are in sanitary operating condition with soap and paper products.
All floors are clean and free of tripping hazards. All kitchen, food preparations and storage areas are kept clean, free of litter, rubbish and free of rodents and other vermin. Storage containers for solid waste, including moveable bins, have tight fitting lids. The facility has one or more functioning carbon monoxide detectors that meet statuary requirements. Water is available inside and outside of the facility for children in care.
Menus are posted at least one week in advance in a place visible by the children's authorized representatives.
The licensee understands that the facility shall not exceed the approved capacity of the fire clearance granted to the facility. The licensee further understands that children cannot be left without supervision, which includes visual supervision.
The licensee was reminded that prior to hiring staff to work or volunteering in a licensed child care facility, all individuals subject to criminal record review, must obtain a criminal record clearance, i.e., fingerprint clearance, PRIOR to being in the presence of day care children.

The licensee provides care for children who require Incidental Medical Services and there is a Plan of Operation on file.
A sampling of Staff and children's records were reviewed during this visit.
The facility uses the multipurpose room as well as the school yard for play. Emergency practices for disaster are done with the school

As a result of this visit, there are no deficiencies cited today.

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda Hollie	TELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

LIC809 (FAS) - (06/04)

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