376700992-1-27-2021-20-CC-RGOU-BXNRR9-20210127121446

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700992
Report Date: 01/27/2021
Date Signed: 01/27/2021 12:14:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	KINDER ACADEMY		FACILITY NUMBER:	376700992
ADMINISTRATOR:	THERESA OSBORN		FACILITY TYPE:	850
ADDRESS:	2605 ALPINE BOULEVARD, SUITE 1		TELEPHONE:	(619) 722-7393
CITY:	ALPINE	STATE: CA	ZIP CODE:	91901
CAPACITY:	60	CENSUS: 27	DATE:	01/27/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	11:23 AM
MET WITH:	Theresa Osborn		TIME COMPLETED:	12:20 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	On 01/27/21 at 11:23 a.m., Licensing Program Analyst (LPA), Rajani Goudreau, made an unannounced case management - Licensee Initiated visit. Facility is requesting to utilize classroom #4, in addition to current licensed classrooms. Upon arrival, LPA met with Owner/Director, Theresa Osborn and proceeded to tour the facility. During this inspection there were 27 children in care. LPA verified all staff members are cleared and associated to the facility. The facility is within licensed capacity/ratio limitations. Business hours are Monday through Friday from 8:45 a.m. to 3:30 p.m. Classroom #4 was inspected and measures a total of 404.78 square feet. Facility is not requesting a capacity increase at this time. Therefore, other licensed preschools classrooms were not re-measured during the inspection. Per tour of the facility today, the proposed classroom #4 is equipped with age appropriate furniture, including tables, chairs, cubbies, bookshelves, and other materials for the children. There is a functioning carbon monoxide detector in the facility and a first aid kit with required supplies. Disinfectants, cleaning solutions, and other hazardous substances shall be kept inaccessible. Drinking water is available in the classrooms via refillable water containers. Children bring reusable water bottles from home or the center will provide disposable cups, if needed. Children will access classroom through the outdoor play area. Required postings are posted near the front entrance of facility. The isolation area is located in the director office and the isolation restroom is located in the staff restroom, if a child becomes ill. The office is located near the front entrance of the facility. Facility is licensed for 12 school age children under the preschool license. Facility will utilize classroom #4 for the school age children during the summer when the classroom is not being used by the preschool age children. Facility submitted a plan of operation reflecting supervision, ratio to be followed, age appropriate activities and co-mingling of children during group activities. Plan of operation is approved. LPA reminded Owner/Director, the facility shall not exceed 12 school age children at any time and shall not exceed the total licensed capacity. Owner/Director acknowledges understanding. Classroom #4 addition is in compliance with standards established in CCR, Title 22, Division 12, Chapter 1, for Child Care Centers and therefore is licensed. The facility will operate in the following classrooms: #1, #2, #3, #4 and the Multi-Purpose room. See LIC809-C continuation page...

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2021

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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KINDER ACADEMY	FACILITY NUMBER: 376700992
	VISIT DATE: 01/27/2021

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

Fire clearance was granted on 11/03/20. Director notified the department of the proposed change on September 29, 2020.

No deficiencies issued throughout today's inspection. An exit interview was conducted with the Owner/Director. The following was discussed and provided: LIC809 reports, LIC9213-Notice of Site Visit and Appeal Rights. LPA informed Owner/Director, Notice of Site visit shall be posted for 30 days from today's date.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2