073407478-6-4-2019-02-CC-MMEA-BCTPXC-20190604114206

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073407478
Report Date: 06/04/2019
Date Signed: 06/04/2019 11:42:16 AM

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:	DIANNE ADAIR DAY CARE CENTERS AT TICE CREEK		FACILITY NUMBER:	073407478
ADMINISTRATOR:	ANGEL, JUDY		FACILITY TYPE:	840
ADDRESS:	1847 NEWELL AVE		TELEPHONE:	(925) 429-3232
CITY:	WALNUT CREEK	STATE: CA	ZIP CODE:	94595
CAPACITY:	150	CENSUS: 0	DATE:	06/04/2019
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Judy Angel & Todd Porter		TIME COMPLETED:	11:53 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	A Case Management Visit was conducted on this date 6/4/19 by Licensing Program Analyst (LPA), Mayla Mendoza. LPA met with center director, Judy Angel and Applicant Todd Porter. The center has applied to remove a portable classroom (Room 2) from their license with no increase in the number of children they are currently licensed for. A health and safety inspection was conducted inside and outside. The center is requesting to be licensed in rooms 1 and Multi-use room. Hours of operation are from 7:00am-6:00pm, Monday through Friday. The rooms are located within Tice Creek Elementary School. INDOORS: EXEMPT OUTDOORS: EXEMPT First aid supplies are available in the center. Facility has a functioning carbon monoxide detector. Outdoor play is right outside of the portable classroom, as well as access to the school play ground. Schoolage children will share the play yard with the preschool program (073408294, capacity 30). Director is reminded that the programs shall not commingle. Shade and drinking fountains are available. Bathrooms are located in the portable classroom, as well as access within school grounds. This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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. A review of staff records on 6/4/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. All staff present today have current CPR/FA.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Mayla Mendoza	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

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: DIANNE ADAIR DAY CARE CENTERS AT TICE CREEK	FACILITY NUMBER: 073407478
	VISIT DATE: 06/04/2019

NARRATIVE

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The center has a current fire clearance for the use of the portable classroom and the multi-use room.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and the director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

There were no deficiencies cited during this visit.

A license for Room 1 and the multi-use room for school aged children will be effective today 6/4/19.

An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Mayla Mendoza	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

LIC809 (FAS) - (06/04)

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