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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005495
Report Date: 07/09/2021
Date Signed: 07/09/2021 02:25:49 PM

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 LLCFACILITY NUMBER:
214005495
ADMINISTRATOR:MAGDA BACHAKASHVILIFACILITY TYPE:
850
ADDRESS:1461 SOUTH NOVATO BLVDTELEPHONE:
(415) 408-3645
CITY:NOVATOSTATE: CAZIP CODE:
94947
CAPACITY:30CENSUS: 0DATE:
07/09/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Magda BachakashviliTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Haydee Caliboso conducted a case management inspection today and met with the Director Magda Bachakashvili in response to a request from the Director for a temporary room change due to construction. The program will move from classroom #1, #2, #3 to classroom #4 and #5 in the building to the existing preschool license starting on July 12th – August 3rd, 2021. LPA Haydee Caliboso inspected the temporary classrooms for health and safety hazards. The temporary classrooms and outdoor space were observed to be clean, safe, and free from hazard. The indoor space for the temporary classroom (#4) was calculated for 851.91 sq. ft. allowing for a capacity of 24 children, (#5) was calculated for 153.45 sq. ft. allowing for a capacity 4 children. The total indoor classrooms measure 1,005.36 sq. ft allowing for a capacity of 28 children. Due to COVID -19, the facility currently has 15 students enrolled. The Director provided the current Child Care Facility Roster LIC 9040. See facility sketch and capacity worksheet and LIC 9040 in file. The temporary classroom has a built-in kitchen counter-top with two sinks and drawers for storage. The classrooms and furniture equipment are clean and in good condition. Children’s toys and supplies are orderly, in good condition, and age appropriate. The facility is equipped with a fire extinguisher, smoke and carbon monoxide detectors. The facility has a first aid kit in and a designated backpack with emergency supplies. The temporary classrooms have 2 toilets and 2 sinks available for children to use. The restrooms are clean and does not have any health or safety hazards. All cleaning supplies and hazardous items are stored in a locked cabinet made inaccessible to children. The isolation area for ill children is in the site supervisor office, and staff bathrooms will be used for ill children. LPA reminded Magda Bachakashvili to ensure ratio and supervision are observed at all times.

Based on today’s inspection LPA will recommend using the temporary rooms #4 and #5 for 28 children.

No deficiencies were observed today. Notice of site visit was observed to be posted and shall remain posted for 30 days.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Haydee R CalibosoTELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021
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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