073408896-11-19-2021-02-CC-LCHW-C8WUTC-20211119145139

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408896
Report Date: 11/19/2021
Date Signed: 11/19/2021 02:51:44 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: 0	DATE:	11/19/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:57 AM
MET WITH:	BHARGAVA, ASMITA S		TIME COMPLETED:	03:10 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 11/19/2021, Licensing Program Analyst (LPA) LaKeisha Chew arrived at facility at 9:20 AM to conduct a Required 1-Year Inspection. LPA met with Bhardava, Asmita Owner/Director. Present for this inspection are the Director/Owner, Assistant Director and one fully qualified teacher, and no school-age children present in care. The facility operates in a single classroom. Facility operating hours are 12:45 PM TO 6:00 PM. Monday – Friday. At 10:06 AM the facility was toured to conduct a health and safety inspection. The classroom is neat and orderly with heating and ventilation for safety and comfort. There are safe age-appropriate toys and learning materials available to children throughout the classroom. All hazardous materials and toxins including disinfectants and cleaning solutions were observed to be made inaccessible to children during today's inspection. Furniture accessible to children was observed to be age-appropriate, in operable condition, and free of loose, sharp, or pointed parts . Facility provides lunch and snacks to children in care daily. Facility menu is posted and available for review. The kitchen is free of litter, garbage, and evidence of rodents or other vermin during this inspection. Food is protected from contamination and, per staff, contaminated food is discarded immediately. Uncontaminated drinking water is available to children inside and outside the facility. LPA observed adequate amounts of paper towels and hand soap available to children in the bathroom during today's inspection. Disaster drills are conducted every six months, the last drill was conducted on 10/2021.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) -69-0243
LICENSING EVALUATOR NAME: Lakeisha Chew	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2021

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: AUTUMN CREEK LEARNING CENTER	FACILITY NUMBER: 073408896
	VISIT DATE: 11/19/2021

NARRATIVE

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There one school-age children’s bathroom with a toilet and sink. The sinks have functioning water taps with appropriate hand washing signs. There are enough disposable towels and soap supplies for children in care. All toilets, hand washing and cleaning area safe, sanitary and operating condition.

LPA performed record reviews. Children files selected were complete and up to date. Staff files were complete. Staff CPR/FA certification and Mandated Reporter Training found to be in compliance with Title 22 regulations.

Childcare roster was reviewed, and copy obtained for file. Classrooms have trash cans with tight fitting cover for the disposal of solid waste.

Individual Medical Services (IMS) policy was discussed. Per Director, no IMS is being provided at this time. The Director was reminded that when any changes to the IMS plan is made, an updated 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.”

No deficiency cited during today’s visit. An exit interview was conducted with the Director. The Director was provided a copy of her appeal rights and the signature on this form acknowledges receipt of these rights.

A Notice of Site visit was posted at the time of inspection and must remain posted for 30 days.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) -69-0243
LICENSING EVALUATOR NAME: Lakeisha Chew	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2021

LIC809 (FAS) - (06/04)

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