073405627-3-22-2023-02-CC-ILOA-CQ72HJ-20230322172450

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073405627
Report Date: 03/22/2023
Date Signed: 03/22/2023 05:25:03 PM

Document Has Been Signed on 03/22/2023 05:25 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 ELEMENTARY		FACILITY NUMBER:	073405627
ADMINISTRATOR:	CARD, G & NGUYEN, L		FACILITY TYPE:	850
ADDRESS:	90 HIGHLAND BLVD, PORTABLE 2		TELEPHONE:	(510) 526-5871
CITY:	KENSINGTON	STATE: CA	ZIP CODE:	94708
CAPACITY:	30	CENSUS: 12	DATE:	03/22/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Jeanne Rehrig		TIME COMPLETED:	05:24 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 March 22, 2023 at 12:01pm, Licensing Program Analyst (LPA) Indira Loza met with Interim Director Jeanne Rehrig for an Unannounced Required Annual Inspection. There were 12 preschool age children and three additional fingerprint cleared staff. The teacher/child ratio was being met today. The center was toured for a health and safety inspection. The facility operates from 8:30am – 5:30pm Monday through Friday. The preschool currently operates out of two portable classrooms with two toilets and four sinks. All sinks and toilets are observed to be clean and in proper working order. The facility has age appropriate materials in all classrooms that are observed to be clean and in good condition. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. Each classroom has a fully charged 2A10BC fire extinguisher. The fire system is hard wired. The outdoor play area is clean with ample age appropriate materials for the children. There are two play structures that are anchored into the ground. The yard is fully fenced in and has shade for the children. The isolation area will be in the far right corner of the classroom. All proper postings are made visible. The school does not provide any meals or snacks for the children. In the event a child forgets a meal or snack, or does not have enough, the facility will provide a small snack and inform the parent/guardian right away. The fire/disaster drill log was complete with the last drill logged 10/17/2022. A physical census of the children and staff were taken and cross referenced with the sign-in and out log. All children were accounted for and properly signed in. All staff have obtained a criminal record clearance. Six children records were reviewed and three staff files were reviewed. Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities to report *************************Report continues on LIC809-C****************

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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: 073405627
	VISIT DATE: 03/22/2023

NARRATIVE

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unusual incidents or injuries 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 email. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

This facility currently is not providing Incidental Medical Services – IMS. For IMS information see PIN CCP 24-02. 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.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Two Type B citations were issued during today's visit. See LIC809-D for deficiencies.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with Interim Director Jeanne Rehrig.
Report and appeal rights provided

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/22/2023 05:25 PM - It Cannot Be Edited

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: 073405627
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/22/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.954

Licensure Requirements

Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above as there was not a Carbon Monoxide detector in the classroom which poses a potential health and safety risk to persons in care.
	POC Due Date: 04/21/2023
	Plan of Correction
1 2 3 4	The Director shall email a picture of a receipt for a purchased Carbon Monoxide Detector and a picture of the detector plugged into the wall.

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as the water has not been tested for lead, which poses a potential health and safety risk to persons in care.
	POC Due Date: 04/21/2023
	Plan of Correction
1 2 3 4	The Director will email a copy of a completed test on the water by April 21, 2023.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC809 (FAS) - (06/04)

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