073408287-7-16-2019-02-CC-PPEN-BE5SHQ-20190716135355

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408287
Report Date: 07/16/2019
Date Signed: 07/16/2019 01:54:13 PM

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:	KIDDIE ACADEMY		FACILITY NUMBER:	073408287
ADMINISTRATOR:	KHARE, RISHU		FACILITY TYPE:	840
ADDRESS:	8680 BRENTWOOD BLVD.		TELEPHONE:	(707) 685-4648
CITY:	BRENTWOOD	STATE: CA	ZIP CODE:	94513
CAPACITY:	14	CENSUS: 0	DATE:	07/16/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Rishu Khare/Shannon Bruce		TIME COMPLETED:	01:50 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	Licensing Program Analysts (LPAs) Paul Petersen and Mayla Mendoza conducted a prelicensing site inspection for this facility. LPAs met with applicant, Rishu Kare, and director, Shannon Bruce. An application has been submitted for a school age license for this facility. The school-age program will be operating in classroom 6. Hours of operation will be from 6:00 AM to 6:30 PM. There is also a preschool program and infant program located at this facility. A health and safety inspection was conducted inside and outside and the measurements are as follows: INDOORS: 478.03 square feet = 14 children OUTDOORS: 12493.16 square feet = 167 children A fire clearance is approved by the ECC Fire Protection Department for 14 children on 07/08/19. The facility has centralized smoke detector/fire alarm system which includes carbon monoxide detector. The school-age program will use the school age play ground, blacktop play area and the preschool area playground with no commingling of children from the other age groups. The outdoor play area is fenced in all around and the climbing structures are age appropriate and securely anchored. There is shade available for the children in the outdoor play area. There are no pools or other accessible bodies of water present. There is an indoor gross motor room which will be shared with the preschool and infant program with no commingling of different age groups an a maximum of 12 children using the room at the same time. The classroom is equipped with age appropriate materials and equipment. There are two sinks and two toilets available for children and both provide privacy. The staff /isolation bathroom for sick children is in the hallway. The isolation area for sick children to rest is the office. There are sleeping cots available. The facility serves meals and snacks and there is a fully equipped kitchen with refrigeration and hot water. Drinking water is available inside via water pitcher and cups and outdoors via water fountain. The center has first aid supplies available. Continued on Page 2**************************************************************************************

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019

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: KIDDIE ACADEMY	FACILITY NUMBER: 073408287
	VISIT DATE: 07/16/2019

NARRATIVE

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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. The facility has electronic sign in, sign out with waiver request on file. The center director has completed 16 hours of health and safety training including pediatric CPR and First Aid.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements was 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 are explained. Appeal Rights were also discussed and provided. The center is found to be clean, safe, sanitary, and in good repair.

A license for 14 children will be issued effective 07/16/2012. An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019

LIC809 (FAS) - (06/04)

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