430703144-9-23-2022-52-CC-SDOO-CJJVLJ-20220923163202

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430703144
Report Date: 09/23/2022
Date Signed: 09/23/2022 04:32:27 PM

Document Has Been Signed on 09/23/2022 04:32 PM - It Cannot Be Edited

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	ACTION DAY NURSERY-PRIMARY PLUS		FACILITY NUMBER:	430703144
ADMINISTRATOR:	JESSICA GUZMAN		FACILITY TYPE:	830
ADDRESS:	333 EUNICE AVENUE		TELEPHONE:	(650) 967-3780
CITY:	MOUNTAIN VIEW	STATE: CA	ZIP CODE:	94040
CAPACITY:	60	CENSUS: 45	DATE:	09/23/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Director Jessica Guzman		TIME COMPLETED:	04:30 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 Friday 9/23/2022 at approximately 9:30am, Licensing Program Analyst (LPA) Sabina Dodoo met with Director Jessica Guzman for an UNANNOUNCED ANNUAL REQUIRED INSPECTION for Action Day Nursery -Primary Plus. Present for the inspection was the Director and 10 teachers who are all fingerprint cleared. The total enrolled children are 60 and the census was 45 children at the time of the inspection. The Child Care Center is opened Monday through Friday from 7am to 6pm. The Child Care Center was toured to conduct a Health and Safety Inspection. LPA toured the Infant component of the center. PHYSICAL PLANT: The entrance of the school is a gate leading to the school building and the classrooms. Parents meet teachers at the classroom door. Parents sign in and out through the Smart Care App. There are 3 classrooms in the infant component. LPA observed cubbies with children’s names where personal items are kept. LPA observed infants sleeping in see through cribs. LPA observed a teacher documenting on the sleep log. There is a laundry area where soiled linens are washed daily. The isolation area is in the Director’s Office. LPA observed the bulletin board (parent’s rights, emergency disaster plan, earthquake drills and facility license). All hazardous materials and toxins are kept out of reach from children and are not accessible. There are multiple fully charged fire extinguishers 3A 10 40 BC located in the classrooms and hallway. There are multiple working carbon monoxide detectors, multiple working smoke detectors, a telephone and a fully stocked first aid kit in the classrooms. The furniture around the classrooms and outdoor area are all child proof and adequate for children to use. The learning materials are organized, and toys are kept in safety bins and cabinets for easy access for the children.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina Dodoo	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: ACTION DAY NURSERY-PRIMARY PLUS	FACILITY NUMBER: 430703144
	VISIT DATE: 09/23/2022

NARRATIVE

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FOOD & SNACK: The school provides AM and PM snacks for the children. Children bring lunch from home. LPA observed infant formula in fridge with childrens name and date. There are no kitchens at this facility.

OUTDOOR: LPA Dodoo observed the outdoor area which consist of small play structures with a slide, small playhouses, and a sandbox free of debris. There is a shaded area and a soft green material all around the play structure to absorb falls. The outdoor play area is also fenced all around with secured gates. There are no bodies of water on the premises. There are no firearms on premises.

RECORDS: LPA reviewed 5 children’s files and 5 staff files and documented them on LIC 859 and LIC 857. An updated roster was viewed by LPA. A copy was provided to LPA by Director. The staff interview was completed with Director Jessica Guzman. Director and staff have completed the Health and Safety training and CPR/First Aid is current. The Director and Staff are following the immunization laws and have completed the mandated reporter training. The Director has conducted and documented the fire and disaster drills twice a year. The last conducted drill was on August 16^th2022. All required forms are posted and visible for public view.

Incidental Medical Services (IMS) policy was discussed. This facility is not providing IMS (Incidental Medical Services) to children currently in care. If 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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina Dodoo	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: ACTION DAY NURSERY-PRIMARY PLUS	FACILITY NUMBER: 430703144
	VISIT DATE: 09/23/2022

NARRATIVE

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Director was reminded that all adults 18 and over working in Child Care Center, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Director was reminded of the responsibility as a mandated reporter and the trainings must be done once every two years as well as CPR/First Aid needs to be renewed every two years and must be EMSA approved. LPA also encouraged licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded. For licensing updates and Quarterly Child Care Distribution email, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Effective August 1, 2003 California Law requires Child Care licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624 within 7 business days.

There are no deficiencies cited during today’s inspection. A notice of site visit was given and must remain posted for 30 days. A copy of Appeal Rights was provided. Exit Interview and staff interview was conducted with Director(Jessica Guzman). This report shall remain on file for the next 3 years.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina Dodoo	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022

LIC809 (FAS) - (06/04)

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