013423043-7-22-2021-52-CC-MOTI-C56RMW-20210722130926

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423043
Report Date: 07/22/2021
Date Signed: 07/22/2021 01:09:32 PM

Document Has Been Signed on 07/22/2021 01:09 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:	OLIVE CHILDREN PRESCHOOL WS		FACILITY NUMBER:	013423043
ADMINISTRATOR:	SHEELA PASI		FACILITY TYPE:	850
ADDRESS:	47385 WARM SPRINGS BLVD		TELEPHONE:	(510) 557-3337
CITY:	FREMONT	STATE: CA	ZIP CODE:	94539
CAPACITY: 79	TOTAL ENROLLED CHILDREN: 0	CENSUS: 11	DATE:	07/22/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Sheela Pasi		TIME COMPLETED:	01:15 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) Melanie Otsuji arrived to the facility unannounced on 7/22/2021 to conduct a Required - 1 Year inspection. LPA met with Director Sheela Pasi. Present during today's visit are 2 staff members and 11 preschool aged children. The center currently operates from 8:30AM to 6:00PM Monday through Friday. LPA toured the facility and play yard for a health and safety inspection. A review of staff records on 7/22/2021 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. (2) Personnel files were reviewed. The teacher/child ratio was being met. (6) Children's files were reviewed. The classrooms and play yard are age appropriate and in good repair. Bathrooms are clean and in working order. The staff have a separate bathroom located within the facility. The sign in and out logs (facility is currently utilizing Procare Software) were reviewed and accurate. Outdoor play area was free of hazards and provided a shaded area for the children and access to drinking water. There is a working telephone. Working carbon monoxide detector, smoke detector and fully charged fire extinguisher were observed at the facility. Opening and closing staff have current CPR and first aid training. LPA observed there are tight fitting lids on trash cans located inside the center. The center documents and conducts fire/disaster drills with the last one documented in January 2021. Director is reminded that ALL assistants, volunteers, frequent visitors that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. See 809-C for second page of report....

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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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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: OLIVE CHILDREN PRESCHOOL WS	FACILITY NUMBER: 013423043
	VISIT DATE: 07/22/2021

NARRATIVE

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Director is reminded that unusual Incidents must be reported within 24 hours by phone. Written report is to follow within 7 days utilizing form LIC624. LPA informed the Director that all forms can be downloaded at www.ccld.ca.gov and encouraged the Director to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Director was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

Individual Medical Services (IMS) policy was discussed. This facility provides IMS to children in care. Facility is following IMS plan on file. When any changes to the IMS plan is made, an updated 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.

LPA is requesting a current copy of LIC500 (Personnel Roster) and Children's Roster be emailed to LPA no later than 8/5/2021.

An exit interview was conducted with the Director. No deficiencies are being cited on today's date. The Director was provided a copy of their appeal rights and the signature on this form acknowledges receipt of these rights. A Notice of Site visit was posted at the time of inspection and must remain posted for 30 days.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

LIC809 (FAS) - (06/04)

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