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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408256
Report Date: 02/27/2023
Date Signed: 02/27/2023 12:48:25 PM


Document Has Been Signed on 02/27/2023 12:48 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:QUEEN OF ALL SAINTS SCHOOLFACILITY NUMBER:
073408256
ADMINISTRATOR:REBECCA LEWFACILITY TYPE:
850
ADDRESS:2391 GRANT STREETTELEPHONE:
(925) 685-8700
CITY:CONCORDSTATE: CAZIP CODE:
94520
CAPACITY:45CENSUS: DATE:
02/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:KRISTINA SPINKTIME COMPLETED:
12:45 PM
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LICENSING PROGRAM ANALYST TASHA ALEXANDER MET TODAY WITH CENTER DIRECTOR KRISTINA SPINK FOR AN UNANNOUNCED 1 YEAR/REQUIRED INSPECTION. TODAY THERE ARE 8 PRESCHOOL AGE CHILDREN PRESENT ALONG WITH 2 STAFF MEMBERS IN THE PRESCHOOL CLASSROOM. THE FACILITY HAS AGE APPROPRIATE FURNITURE AND NAPPING EQUIPMENT WHICH APPEARS TO BE IN GOOD REPAIR. THE INDOOR AND OUTDOOR ACTIVITY SPACE APPEARED TO BE IN GOOD REPAIR. DISINFECTANTS, CLEANING SOLUTIONS, POISONS AND OTHER ITEMS THAT ARE DANGEROUS TO CHILDREN WERE INACCESSIBLE DURING TODAY'S INSPECTION. THE SINKS WERE OBSERVED TO BE IN OPERABLE CONDITION. THE FLOORS ARE FREE OF TRIPPING HAZARDS. LUNCHES AND SNACKS ARE BROUGHT FROM HOME. ALL STORAGE CONTAINERS FOR SOLID WASTE HAVE TIGHT FITTING LIDS THAT ARE IN GOOD REPAIR. DRINKING WATER IS AVAILABLE BOTH INDOORS AND OUTDOORS. SIGN IN SHEETS WERE REVIEWED. OUTDOOR ACTIVITY SPACE AND PLAYGROUND EQUIPMENT WAS OBSERVED TO BE SAFE AND FREE OF HAZARDS WITH APPROPRIATE MATERIAL TO ABSORB FALLS. THERE ARE TREES TO PROVIDE SHADED AREAS FOR CHILDREN.

THE FACILITY IS OPERATING WITHIN IT'S LICENSED CAPACITY. THE FACILITY IS WITHIN RATIO TODAY. LPA DID NOT OBSERVE ANY CHILD LEFT WITHOUT SUPERVISION DURING INSPECTION. LPA VERIFIED THAT ALL STAFF HAS CURRENT CPR/1ST AID TRAINING CARDS. A PHYSICAL CENSUS WAS TAKEN OF ALL CHILDREN PRESENT AND CROSSED REFERENCED WITH THE SIGN/OUT SHEETS.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
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: QUEEN OF ALL SAINTS SCHOOL
FACILITY NUMBER: 073408256
VISIT DATE: 02/27/2023
NARRATIVE
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A SAMPLE OF CHILDREN'S RECORDS WERE REVIEWED. FILES REVIEWED CONTAINED EMERGENCY INFORMATION AND CURRENT IMMUNIZATION RECORDS. STAFF RECORDS REVIEWED HAVE REQUIRED HEALTH SCREENING AND CURRENT MANDATED REPORTER CERTIFICATES. TEACHERS PRESENT TODAY MEET QUALIFICATION REQUIREMENTS.

Licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023
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: QUEEN OF ALL SAINTS SCHOOL
FACILITY NUMBER: 073408256
VISIT DATE: 02/27/2023
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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

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.

As a result of this visit, there are no deficiencies cited today. An exit interview was conducted. A notice of site visit was posted.

SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 02/27/2023 12:48 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: QUEEN OF ALL SAINTS SCHOOL
FACILITY NUMBER: 073408256

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care. THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY A REVIEW OF STAFF RECORDS WHICH REVEALED 1 STAFF MEMBER ANA BARAJAS DOES NOT HAVE PROOF OF THE MEASLES VACCINE IN FILE
POC Due Date: 03/13/2023
Plan of Correction
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LICENSEE WILL HAVE THE STAFF MEMBER OBTAIN A COPY OF HER IMMUNIZATION RECORD WITH PROOF OF THE MMR/MEASLES VACCINE OR BLOOD TEST RESULTS AND SUBMIT A COPY TO COMMUNITY CARE LICENSING BY 3/17/23.
Section Cited
Deficient Practice Statement
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101215.1 Child Care Center Directors Qualifications and Duties
(a) In addition to Section 101215, the following shall apply:
(m) A child care center director shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866. THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY: A REVIEW OF STAFF RECORDS REVEALED TODAY, THE CENTER DIRECTOR DID NOT HAVE PROOF OF COMPLETION OF HEALTH AND SAFTEY TRAINING IN FILE.
POC Due Date: 03/20/2023
Plan of Correction
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 LICENSEE WILL OBTAIN A COPY OF HER HEALTH AND SAFETY CERTIFICATE OR COMPLETE THE 8 HOURS OF TRAINING AND SUBMIT A COPY OF THE CERTIFICATE TO COMMUNITY CARE LICENSING BY 3/20/23
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: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
LIC809 (FAS) - (06/04)
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