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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408215
Report Date: 02/28/2020
Date Signed: 02/28/2020 10:17:35 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:SRVSACCA - TWIN CREEKSFACILITY NUMBER:
073408215
ADMINISTRATOR:GILLUM, ASHLEYFACILITY TYPE:
840
ADDRESS:2785 MARSH DR.TELEPHONE:
(925) 743-3155
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY:130CENSUS: 9DATE:
02/28/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Sydney Canto & Marnie SowaTIME COMPLETED:
10:30 AM
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A Case Management Visit was conducted on this date 2/28/20 by Licensing Program Analyst (LPA), Mayla Mendoza. LPA met with Assistant Director, Sydney Canto. Later, Director Marnie Sowa arrived. The center has submitted an application for an increase in capacity from 130 to 147 school aged children, and to add room R6. Center is located on the premises of Twin Creeks Elementary School. The center will now be operating in 3 rooms (2 portables and R6). Hours of operation are from 6:30am-6:30pm, Monday through Friday. Staff files were reviewed today at 9:30 am. Proper teacher-child ratio was observed during this visit. A health and safety inspection was conducted inside and outside.

Openers and closers have current CPR/FA. Children use the school playground. play structures, and black top. Playground equipment is in good condition. Climbing structures have sufficient cushioning by use of poured rubber to absorb a fall. Drinking water is available inside and outside by way of water fountains and water cooler and cups. All toilets and handwashing facilities are in safe and sanitary operating conditions. There is a kitchen inaccessible to children. Menus are posted. Snacks are provided and prepared on site. There is adequate variety and quantity of foods to meet the children's needs. Electronic and manual sign in and out logs are being utilized. Facility has a functioning carbon monoxide detector. First aid kits are available.

This facility plans to provide Individual Medical Services – IMS. 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.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: SRVSACCA - TWIN CREEKS
FACILITY NUMBER: 073408215
VISIT DATE: 02/28/2020
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A review of staff records on 2/28/20 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The center has obtained an approved fire safety inspection from the San Ramon Valley Fire Department. All licensing required documents are posted.

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.

Zero Tolerance policies were explained. Notice of Site Visit form was provided and posted.
The center was found to be clean, safe, sanitary and in good repair. There are no deficiencies cited during this visit. A license for 147 schoolaged children and use of Room R6 will be issued effective today 2/28/20.

An exit interview was conducted.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020
LIC809 (FAS) - (06/04)
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