214005495-8-9-2019-05-CC-PHSH-BEVNYW-20190809105326

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005495
Report Date: 07/17/2019
Date Signed: 08/09/2019 10:53:33 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	ALPHA KIDS ACADEMY LLC		FACILITY NUMBER:	214005495
ADMINISTRATOR:	BACHAKASHVILI, MAGDA		FACILITY TYPE:	850
ADDRESS:	1461 SOUTH NOVATO BLVD		TELEPHONE:	(415) 664-8080
CITY:	NOVATO	STATE: CA	ZIP CODE:	94947
CAPACITY:	30	CENSUS:	DATE:	07/17/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:55 AM
MET WITH:	Magda Bachakashvili & Natella Shtern		TIME COMPLETED:	01:20 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 Analyst (LPA) Pandora Huffman-Smith met with the applicants, Magda Bachakashvili and Natella Shtern today for a pre-licensing inspection. The applicants are requesting 30 children (ages 2-6 years old). This is a relocation from 495 San Marin Drive in Novato. The facility is located in the rear of the Quest Church and will operate Monday - Friday from 7:30 AM to 6:00 PM. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity. Indoor: There are 3 classrooms (Adventurers for 2 year old children, Explorers for children 3 years of age and Navagator’s for children ages 4-5 years of age. There is also a multipurpose room that will be used. The rooms measure a total of 1506 square feet allowing for a capacity of 43 children. The classrooms appear to be clean and furnishing, toys and equipment appear to be safe and in good condition. The facility is equipped with smoke detector and food prep area. There is one bathroom for children's usage that is equipped with two toilets and one sink. The bathroom appears to be clean and with no apparent health and safety hazards. There is an additional sink in the hallway for children’s usage. Total allowable capacity for toilets and sinks is 30. There is a separate bathroom for staff usage. Isolation of ill children will be located in the staff office and staff bathroom will be used for the ill child until the parent arrives for pick up. Outdoor: There are two separate outdoor areas. The yard for 2 and 3 year old children measures 1223 square feet allowing for a total of 16 children and the outdoor area for the older children measures 827 square feet allowing for a total of 11 children. LPA advised that a waiver will need to be submitted and approved for scheduled rotational usage for each yard. The outdoor area for the older children is equipped a play structure. Continued on page 2

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Pandora Huffman-Smith	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ALPHA KIDS ACADEMY LLC	FACILITY NUMBER: 214005495
	VISIT DATE: 07/17/2019

NARRATIVE

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The facility will conduct disaster drills once monthly and will maintain a log for review.

The following are requirements prior to licensure:

Fire clearance required
Fire extinguisher and carbon monoxide detector.
Rocks to be removed from the outdoor play area and cushioning installed underneath the play structure
Plan of operation for incidental medical services (IMS)
Cubbies needed for children
Napping equipment
First aid supplies
Facility postings

A follow up inspection will be conducted to review the corrections.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Pandora Huffman-Smith	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019

LIC809 (FAS) - (06/04)

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