073408876-9-20-2019-02-CC-WNOA-BG7SKA-20190920135623

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408876
Report Date: 09/20/2019
Date Signed: 09/20/2019 01:56:59 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:	SKYTOWN PRESCHOOL		FACILITY NUMBER:	073408876
ADMINISTRATOR:	MELGOZA, MARTHA		FACILITY TYPE:	850
ADDRESS:	5714 SOLANO AVENUE		TELEPHONE:	(510) 701-4855
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94805
CAPACITY:	36	CENSUS: 0	DATE:	09/20/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Martha Melgoza		TIME COMPLETED:	02:15 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	An announced Prelicensing inspection was conducted today, September 20, 2019 by Licensing Program Manager (LPM) Wynn Norona. LPM met with applicant/director Martha Melgoza, Board members, Brionna Garner and Thao Nguyen. The center has submitted an application for 36 Preschool license with 12 Toddler-Option. The center is located next to Mt. Zion Lutheran Church and will be running a Parent Coop Program utilizing two rooms in a portable. The Toddlers will have a separate entrance. The center will operate Monday-Friday from 8am to 3pm. LPM conducted a health and safety inspection inside and outside and the measurements are as follows: INDOOR: 1493.4 square feet = 42 children OUTDOOR: 5395 square feet = 72 children The center has obtained a fire clearance approval from City of Richmond Fire Department on 9/11/19. There are 5 sinks and 3 toilets available for children to use. The staff has a separate bathroom which will also be used as isolation area for sick children. The director's office will be used as the isolation area for sick children. There are no bodies of water nor any firearms or weapons in the premises. Storage for cleaning supplies are locked and made inaccessible to children. Furniture and equipment are free of any hazards. The classrooms are equipped with age appropriate materials and equipment. There are smoke detectors, carbon monoxide detectors, and fire extinguishers available all throughout the center. Heating, lighting, and air conditioner are adequate. First Aid Kit is available. Each child has individual storage for their belongings. The play yard is fenced in all around. Shades/canopy provide sufficient shade in the play yard. The center will bring water outside during children's activity. The parents will provide snacks and lunch for their children but the center also has an emergency snacks available for children. --------------------------------- CONTINUED ON PAGE 2 -----------------------------------------------

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019

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: SKYTOWN PRESCHOOL	FACILITY NUMBER: 073408876
	VISIT DATE: 09/20/2019

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.

Martha Melgoza has completed 8 hours of pediatric CPR and First Aid training which expires on 1/21/20 and also completed the 8 hours of preventive health and safety training. The director understands that prior to working or volunteering in a licensed child care facility, all individuals subject to criminal record review shall obtain a clearance or criminal record exemption. If the department notifies the licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons the licensee shall comply. The director was encouraged to email ChildCareAdvocatesProgram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

An exit interview was conducted with the applicant/director Martha Melgoza and Board Members. Zero Tolerance policies were explained. LPM reminded Ms. Melgoza to review Title 22, section 101216.5 for staffing Parent-Cooperative Centers. LPM provided a copy of the appeal rights and the signature on this form acknowledges receipt of these rights. LPM reminded the director that once licensed, the facility must be in compliance with all licensing laws and regulations. If the center is in violation of any laws or regulations, a citation will be issued.

A license for 36 preschool children with 12 Toddler-Option is recommended effective today, September 20, 2019.

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019

LIC809 (FAS) - (06/04)

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