393620820-3-5-2020-53-CC-SWIS-BMEUXD-20200305145810

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393620820
Report Date: 03/05/2020
Date Signed: 03/05/2020 02:58:15 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	CAPC - MOUNTAIN VIEW		FACILITY NUMBER:	393620820
ADMINISTRATOR:	SAGUIGUIT, VAN		FACILITY TYPE:	850
ADDRESS:	377 W. MOUNT DIABLO AVE. #20		TELEPHONE:	(209) 464-4524
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	24	CENSUS: 17	DATE:	03/05/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Cherryl Balatbat		TIME COMPLETED:	03:15 PM

NARRATIVE

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On March 5, 2020, Licensing Program Analyst (LPA) Stacey Williams arrived at the facility for the purpose of conducting an annual inspection. LPA met with Program Manager, Cherryl Balatbat. The facility operates Monday thru Friday, with staff working 7:30 AM to 5:30 PM.

Children were napping during LPA’s arrival to the facility. LPA toured the inside of the center at 12:40 PM with the Program Manager and observed (17) seventeen children supervised by three staff. While inspecting the facility, LPA observed all cleaning supplies and hazardous items are stored in locked cabinets inaccessible to children. Restrooms were sanitary and in operating condition. Storage containers for solid waste had lids. Drinking water was readily available inside. The facility utilizes water jugs for outside water usage.

Program provides breakfast, lunch, and snack. LPA observed a menu posted on the bulletin board at the entry of the classroom. LPA toured the kitchen area of the classroom. Food preparation area is clean, food is protected from contamination, and all food or beverages are stored in covered containers and labeled. Meals are delivered daily from an outside entity.

Required Licensing postings were viewed on the bulletin board at the entry of the classroom. LPA viewed the signatures on the sign in and out sheets located near the classroom front door. Fire drills are conducted and documented to meet regulation standards. LPA was informed that fire drills are conducted monthly. Fire drill log was located on the wall near the classroom front door. Carbon Monoxide and smoke detectors were present and operable.

At 1:15 PM LPA toured the outdoor activity space with Program Manager, Cherryl Balatbat. The playground equipment and outdoor activity space is maintained and in good repair. Foam matting is being used as cushioning around the climbing equipment to absorb falls. Water is readily available outside.

Report Continues on 809-C

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: CAPC - MOUNTAIN VIEW	FACILITY NUMBER: 393620820
	VISIT DATE: 03/05/2020

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At 1:30 PM, LPA reviewed children’s files and observed they included information pertaining to their authorized representative, consent for medical treatment and a medical assessment form.

LPA reviewed a random sample of staff records which included a current CPR/First Aid, immunization records. First Aid certification expires in September 2020. Staff have Mandated Reporter training completion certificates. Documentation of educational background, training, and/or experience was observed in each file. Criminal record clearances were verified.

Incidental Medical Services (IMS) policy was discussed. A Plan of Operation is available in the facility file. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a 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.

At 2:15 PM children were transitioning from nap to snack time. LPA observed children sanitizing their hands prior to eating snack. Supervision for indoor activities was observed at 2:45PM. Capacity and ratio requirements were being met.

There are no deficiencies being cited based on LPA’s tour of the facility, observations, and review of records during today’s inspection.

LPA discussed the implementation of AB 2370, lead exposure with Program Manager, Cherryl Balatbat. Program Manager was encouraged to visit the departments website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

An exit interview was conducted, and the licensing report was reviewed with Program Manager. A copy of this report and appeal rights were discussed and left with Cherryl Balatbat whose signature on this form confirm receipt of these documents. Notice of Site Visit was provided to post during today’s inspection.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

LIC809 (FAS) - (06/04)

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