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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405027
Report Date: 04/28/2023
Date Signed: 04/28/2023 01:45:01 PM


Document Has Been Signed on 04/28/2023 01:45 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:NEIGHBORHOOD SCHOOL AT KENSINGTON ELEMENTARYFACILITY NUMBER:
073405027
ADMINISTRATOR:CARD, G & NGUYEN, LFACILITY TYPE:
840
ADDRESS:90 HIGHLAND BLVDTELEPHONE:
(510) 526-5871
CITY:KENSINGTONSTATE: CAZIP CODE:
94708
CAPACITY:150CENSUS: 0DATE:
04/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:18 AM
MET WITH:Jeanne RehrigTIME COMPLETED:
01:54 PM
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On April 28, 2023 at 11:18am, Licensing Program Analyst (LPA) Indira Loza conducted an unannounced Annual Inspection. LPA met with facility representative Jeanne Rehrig and explained the purpose of today's inspection. All adults in the facility have a criminal background clearance. The facility was toured for a health and safety inspection. The operating days and hours are Monday - Friday from 1:30pm - 5:30pm.

Indoor space: Facility operates out of two classrooms, a portable classroom, and a multipurpose room. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to children. 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 any tripping hazards. Trash cans for solid waste had tight-fitting covers on and were in good repair. LPA observed a fully charged fire extinguisher, a working Smoke detector and working Carbon Monoxide Detectors. The last Fire Drill was conducted on October 2022. Facility does not provide transportation. Facility’s License, Parents’ Rights, and Personal Rights, were observed to be posted.

Outdoor Space: There is a small playground for the Kindergartners and a large playground on the opposite side of the campus for the older children. The playgrounds were inspected and observed to be fully fenced and safe. The play equipment was maintained in good condition and free of hazards. Areas around and under high climbing equipment were cushioned with material that absorbs falls. LPA Observed plenty of shade for the children in care. There were no bodies of water observed.

File Review: All files contained required documents. There was at least one staff with current certification in Pediatric CPR/First Aid present at the facility during today's inspection. Children's Roster and personnel


***********************Report Continues on LIC 809-C***********************
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:
DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/28/2023
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: NEIGHBORHOOD SCHOOL AT KENSINGTON ELEMENTARY
FACILITY NUMBER: 073405027
VISIT DATE: 04/28/2023
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report was reviewed, and a copy obtained. The facility is currently not providing any Incidental Medical Services.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02. 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 is reminded that any person who works in a child care facility shall complete Mandated Reporter training and renew the training every 2 years at Mandatedreporterca.com. California Law requires Child Care Centers to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or e-mail. The Children's Roster must be properly maintained, and fire/disaster drill every six months must be documented.

Staff 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/ction-process.

There were no deficiencies cited during today's visit.

Exit interview conducted with Director Jeanne Rehrig.

Report and Appeal Rights Provided.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023
LIC809 (FAS) - (06/04)
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