<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423794
Report Date: 10/13/2025
Date Signed: 10/13/2025 02:20:14 PM

Document Has Been Signed on 10/13/2025 02:20 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:PETER PAN ACADEMYFACILITY NUMBER:
013423794
ADMINISTRATOR/
DIRECTOR:		THERESA CLEMENTFACILITY TYPE:
860
ADDRESS:3171 MECARTNEY ROADTELEPHONE:
(949) 299-7263
CITY:ALAMEDASTATE: CAZIP CODE:
94502
CAPACITY: 74TOTAL ENROLLED CHILDREN: 74CENSUS: 0DATE:
10/13/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Prashant WadhwaTIME VISIT/
INSPECTION COMPLETED:
02:45 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 Monday, October 13, 2025, Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) M. Domantay met with Applicant Prashant Wadhwa for the purpose of a pre-licensing inspection for a change of ownership. Applicant requests a single licensed child care center for an infant program 0 to 2 years (capacity 11) and preschool program ages two years to first grade entry (capacity 63) license to serve a total of 74 children. The program will operate Monday through Friday from 7:00 a.m. to 6:00 p.m. The fire clearance was granted and approved on 6/12/2025 from the City of Alameda Fire Department. The facility will not provide food, all food will be provided from home. Facility has emergency snacks if needed.

LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

INDOOR ACTIVITY SPACE:
There are 4 areas for the preschool program: Classroom 1 (3 year olds), Classroom 2 (2 year olds), Classroom 3 (Pre-K), Classroom 4 (dining/art room). There is 1 area for the infant program: Classroom 5. LPA observed sufficient amount of equipment, toys, tables, chairs, and mats during today's inspection. LPA observed a first aid kit available in each classroom. Facility does not administer medications, per Applicant no medications is stored within the facility. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. LPA observed a functional carbon monoxide detector in the kitchen of the facility. LPA observed a kitchen in the facility with a door, per Applicant, kitchen remains locked and inaccessible to children. LPA observed an electronic sign-in/sign-out system. Page 1
NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Melissa Domantay
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2025
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 5
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: PETER PAN ACADEMY
FACILITY NUMBER: 013423794
VISIT DATE: 10/13/2025
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
LPA measured all indoor classroom areas for the infant and preschool programs. There are 6 toilets and 9 sinks available for preschool children located in the hall, and a separate private restroom for the staff is located within the facility. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the Director's office and will use the staff restroom, if necessary.

The total preschool classroom space contains a total of 2315.65 square feet, which will accommodate Applicant's request for 63 preschool children. The total infant classroom space contains a total of 399.70 square feet, which will accommodate Applicant's request for 11 infant children. LPA observed changing table on the counter in the infant classroom that is not sufficient. LPA provided regulation to Applicant and notified Applicant changing table must have raised sides at least 3 inches high. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).



OUTDOOR ACTIVITY SPACE:
There is 1 preschool outdoor area and 1 infant outdoor area. All outdoor play areas is fenced with wooden fencing that is at least four feet tall all around. LPA observed a sufficient amount of equipment and toys. There are play structures in the preschool play yards and a sandbox area that were observed to be free of debris and maintained. Play structures are filled with tan bark as cushioning to cushion a child's fall. LPA reminded Applicant to follow manufacturer guidelines on the play structures in the preschool play yard, LPA observed a manufacturer sticker on each play structure that stated the play structures are designated for children ages 2-5 years old. The infant play yard has a metal gating as barrier between the infant and preschool play yard areas. The infant play yard area is cushioned with turf to cushions a child's fall. There are no bodies of water on the premises. LPA observed a lagoon outside of the facility which is inaccessible to children by the all around wooden fencing that is over 4 feet tall and has a lock on the wooden fence door. LPA reminded Applicant to ensure to empty all water tables when not in use. There is sufficient shading areas provided by trees, canopies, and wooden awnings in the preschool and infant play yards.

LPA measured all outdoor areas for the infant and preschool programs. The Preschool outdoor play area contains a total of 5130.05 square feet, which will accommodate Applicant's request for 63 preschool children. The Infant outdoor play area contains a total of 349.14 square feet, which will not accommodate Applicant's request for 11 Infant children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Page 2
NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Melissa Domantay
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: PETER PAN ACADEMY
FACILITY NUMBER: 013423794
VISIT DATE: 10/13/2025
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
LPA notified Applicant a waiver must be submitted for the outdoor infant play area to accommodate the maximum capacity of 4 infant children outdoors at any given time with a set schedule in place.

LPA discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA discussed with Natasha any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes 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) or (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



Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Page 3
NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Melissa Domantay
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: PETER PAN ACADEMY
FACILITY NUMBER: 013423794
VISIT DATE: 10/13/2025
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
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

Exit interview conducted and report was reviewed with the Applicant, Prashant Wadhwa.

The following items are required before a license will be issued:

1. Licensing Program Manager (LPM) final file review.

2. Applicant must install an alarm at the entrance of the facility and sent photos and videos to LPA.

3. Applicant must purchase a changing table in regulation with 3 inches raised sides, in hands reach of a sink and send photos to LPA.

4. Applicant must install gating/barrier in the infant outdoor play yard for the additional space they are adding for the infant program and send photos to LPA.

5. Applicant must submit a waiver for the outdoor infant play area to accommodate the maximum capacity of 4 infant children outdoors at any given time with a set schedule in place.

6. Applicant must remove cribs from the infant classroom.

Page 4

NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Melissa Domantay
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5