073408896-2-12-2021-02-CC-LDYN-BY6TR8-20210212135707

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408896
Report Date: 11/24/2020
Date Signed: 02/12/2021 01:57:12 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:	AUTUMN CREEK LEARNING CENTER		FACILITY NUMBER:	073408896
ADMINISTRATOR:	BHARGAVA, ASMITA S.		FACILITY TYPE:	840
ADDRESS:	14 OSBORN WAY		TELEPHONE:	(925) 743-4187
CITY:	DANVILLE	STATE: CA	ZIP CODE:	94526
CAPACITY:	30	CENSUS:	DATE:	11/24/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Asmita Bhargava		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	On 11/24/20 at 1:15pm Licensing Program Analyst (LPA) Loretta Dyson conducted a prelicensing tele-inspection thru the FaceTime application. A tele-inspection was done due to the COVID-19 pandemic. LPA met with the owner/director, Asmita Bhargava. There were a total of 61 preschoolers and school age children that were in care today. An application for a change of ownership of this center was received. This is the school age component of this combination center, which also has a preschool component. The program will operate Monday-Friday 7am-6pm in one classroom. A tour of all areas that will be used by and for children was completed to conduct a health and safety inspection. The owner pointed the camera around the areas so LPA could make observations. The owner confirmed that there have been no changes made which affected the square footage of the classrooms or playgrounds, so the measurements completed under the old ownership on 8/27/99 will be used for now. Those measurements are as follows: INDOORS: 1,128.11 square feet= 32 children OUTDOORS: 12,431 square feet= 165 children A fire clearance, for a capacity of 80 preschool age children and 30 school age children, was received from San Ramon Valley Fire, on 10/13/20. LPA observed that the center has sufficient heating, lighting and ventilation for the safety and comfort of children and staff. The classroom floors and surfaces appeared to be clean and in good repair. LPA observed an ample supply of age appropriate toys, activities, equipment and storage available for children. The center is equipped with carbon monoxide detectors, a centralized sprinkler/smoke detection and alarm system, fully charged fire extinguishers, working telephones, and first aid supplies. LPA observed that the food preparation area is clean and LPA did not observe any food stored with cleaning supplies. The center provides morning and afternoon snacks and lunch and serves fat free milk to children.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:	DATE: 11/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/24/2020

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: AUTUMN CREEK LEARNING CENTER	FACILITY NUMBER: 073408896
	VISIT DATE: 11/24/2020

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
26
27
28
29
30
31
32

Water is available for children both indoors and outdoors with water pitchers, for each classroom and outdoor space, and disposable cups. LPA observed all required documents posted, including a menu that is dated at least a week in advance, and COVID-19 postings. LPA did not observe any bodies of water, hazardous items or toxins that would be accessible to children. There are 2 toilets and 2 sinks available for children, and a separate bathroom school age children and for staff. The office and staff bathroom will be used for the isolation of sick children.

The outdoor play areas are fully fenced and shade is provided with canopies and trees. The play structures have sufficient cushioning underneath to absorb a fall. LPA did not observe any defects or hazardous conditions. The center would like to share the large playground between the preschool and school age components and a waiver request will be processed.

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated 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.

LPA has reviewed documents and verified that Asmita Bhargava is qualified as a preschool and school age director.

The director is reminded of the following: commingling between the programs is not allowed; the mandated reporter training needs to be completed by all staff, and renewed every 2 years at www.mandatedreporterca.com; staff need to have a criminal record clearance and be associated to this facility, prior to employment and working with children, or a civil penalty can be accessed; injuries requiring medical attention and unusual incidents need to be reported by the next business day with a written report sent within 7 days after the injury/incident; maintain the required ratio and supervision, and operate within the terms of the license at all times.

The facility will be issued a provisional preschool license, with a maximum capacity of 30 children, effective today November 24, 2020. The new requirement for Lead Prevention training as part of Preventative Health and Safety, effective July 1, 2020, will need to be completed before the regular license is issued. The owner has provided proof of enrollment in this course. This report shall remain on file for 3 years. An electronic signature will not be obtained, but the report will be sent to the owner for signature.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:	DATE: 11/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/24/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2