073404859-5-15-2019-02-CC-GRED-BC7S8N-20190515133922

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073404859
Report Date: 05/15/2019
Date Signed: 05/15/2019 01:39:50 PM

COMPREHENSIVE INSPECTION

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:	SUPER KIDZ CLUB		FACILITY NUMBER:	073404859
ADMINISTRATOR:	NICOLE BURNS		FACILITY TYPE:	840
ADDRESS:	2140 MINERT ROAD		TELEPHONE:	(925) 682-0143
CITY:	CONCORD	STATE: CA	ZIP CODE:	94518
CAPACITY:	30	CENSUS: 0	DATE:	05/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Nicole Burns, Director		TIME COMPLETED:	09:30 AM

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) Redmond, arrived at the facility unannounced, to conduct an Annual/Random, health and safety inspection. The purpose of the inspection is to ensure the facility is in compliance with Title 22, CCR and Health and Safety Code Statutes for Child Care Centers. During the inspection, LPA met with Nicole Burns, Director. During the inspection, LPA made the following observations: Capacity/Staffing: There are currently no school aged children present. On Limit areas which are accessible to children include: Two Classrooms, Sleep Area, Dining area, Restroom, Play yard. Off Limit areas which are not accessible to children include: Kitchen, Office, Infant area At the entrance to the facility are the required postings: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist. If You See Something, Say Something was added on this date. Parents use a daily sign in sheet to sign in their children. There is an updated Child Care facility roster. Classroom: Furniture and equipment age appropriate and in good repair. Adequate heating, lighting and ventilation. There is separate storage for children’s belongings. There are mats available to each child. Children’s mats are cleaned daily and their bedding is taken home and laundered every week. Some children bring food, others eat at the facility. The day care prepares a food, a menu is posted. CONTINUED

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: SUPER KIDZ CLUB	FACILITY NUMBER: 073404859
	VISIT DATE: 05/15/2019

NARRATIVE

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Restroom: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use. There are no cleaning solutions or toxins accessible to children.

Play yard: Enclosed by fence. There is a wooden climbing structure which, is anchored, however, should be reinforced. In the infant area, tents have been installed, which must be anchored. There are trees which provide a shaded area. Playground is free of debris and other hazards. Drinking water readily available. No pools or other bodies of water present.

Emergency Preparedness/Safety: Smoke detectors are located throughout the facility and inspected and tested by a professional company. Fire extinguishers were also tested. There are multiple fire extinguishers throughout the facility. There is a carbon monoxide detector, which, per Director is connected to the fire extinguisher. First aid supplies available. Emergency Disaster Plan is dated 3/10/16 and is current, per the Director. Fire and earthquake drills were last conducted on 05/01/19 and meet the six (6) month requirement. The facility utilizes a land line telephone for telephone service. The facility is not currently providing *Incidental Medical Services (IMS) however, is aware of IMS requirements.

Exit interview conducted. This Facility Evaluation Report discussed with the Licensee and signature obtained below. Notice of site visit was issued and shall be posted remain posted for 30 days. Failure to keep this notice posted for the 30 consecutive days will result in an immediate $100 civil penalty. A copy of this report shall be maintained for 3 years and available for public review upon request.

NO DEFICIENCIES CITED ON THIS DATE.

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
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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