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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700583
Report Date: 10/25/2023
Date Signed: 10/25/2023 01:10:50 PM


Document Has Been Signed on 10/25/2023 01:10 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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:BUILDING KIDZ OF DUBLINFACILITY NUMBER:
015700583
ADMINISTRATOR:ASHLEY SANCHEZFACILITY TYPE:
850
ADDRESS:6351 DUBLIN BOULEVARDTELEPHONE:
(650) 777-5301
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:60CENSUS: 27DATE:
10/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Director, Ashley SanchezTIME COMPLETED:
01:30 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
Licensing Program Analyst (LPA) Jyoti Saini met with facility representative, Ashley Sanchez,for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility. In addition to the Director and six teachers, 27 children present today. This program currently operates Monday- Friday, 7:00 am – 6:00 pm in room #101 (AKA Nature Ville), room # 102 (AKA Performance Art), Room # 103 (AKA Discovery Ville), Room # 104 (AKA Exploratorium ) and room #105( AKA Young explorer, which is exclusively for toddlers). The building has a second floor, and the Director understands that no children shall be allowed on the second floor of the building. The facility was inspected indoors and outdoors today for health and safety hazards, and the following was observed:
There are no bodies of water, firearms, or weapons on the premises. The Center is in good condition with proper temperature and ventilation, and is free of hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. The facility has a waiver for outdoor space, present and visible for review. A first aid kit and a first aid backpack are available. The program provides lunch and snacks to the children in care. LPA reviewed food storage and reminded the Director that all food must be in original packaging or labeled with an expiration date, ensuring different foods do not cross-contaminate. Cleaning supplies/toxins are stored and inaccessible to children during the inspection. The classroom has appropriate postings. The last Emergency Drill was conducted on 08/23 and is appropriately logged. LPA reviewed the sign-in and out sheet. The Center has a complete record of sign-in/out sheets by an authorized pick-up person. The children and staff have a separate bathroom. The bathrooms appear safe, sanitary, and free of any hazardous items. Drinking water is readily available through water bottles brought from home, and the Center uses barita jugs to refill the water bottles. The cots are cleaned by the staff daily, and the parents wash the blankets weekly. During the inspection, the facility was suggested to have 15 minute sleep check. (see LIC9102)
The center roster was reviewed, and a copy was obtained. A review of ten children's files and six staff files was completed. All children have a record of emergency identification information and immunization records on file. All staff members have a criminal record clearance on file. The Director was reminded that the opening and closing staff should have a current Pediatric First Aid/CPR certificate. All the staff members have Mandated Reporter training. Per the Director, no children are on medications, and IMS services are not provided.
See next page...
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2023
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 3


Document Has Been Signed on 10/25/2023 01:10 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612


FACILITY NAME: BUILDING KIDZ OF DUBLIN
FACILITY NUMBER: 015700583

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101227(a)(1)
Food Service
(1) All food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. Each meal shall include, at a minimum, the amount of food components as specified by Title 7, Code of Federal Regulations, Part 226.20, (Revised January 1, 1990) Requirements for Meals, for the age group served. All food shall be selected, stored, prepared and served in a safe and healthful manner.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above as there was 3.5% milk in the refrigerator (instead of 1% or non-fat milk) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/25/2023
Plan of Correction
1
2
3
4
The deficiency was cleared during the visit as the 3.5% milk was disposed of, and the facility brought 1% milk.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: BUILDING KIDZ OF DUBLIN
FACILITY NUMBER: 015700583
VISIT DATE: 10/25/2023
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
During inspection,

Criminal Record Clearance -

Facility representative was reminded that all adults 18 and over, 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 Childcare 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.

Lead Testing –


CCC COMPLETED TESTING AND IS IN THE PROCESS OF REMEDIATING LEAD EXCEEDANCES
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Incidental Medical Services (IMS)
This facility does not provides Incidental Medical Services –
For IMS information see PIN 22-02-CCP. 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 Childcare Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

MyChildCarePlan.org
Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Type B deficiency is cited today and one technical violation was given.

A notice of site visit was given and must remain posted for 30 days.



Exit interview conducted and report was reviewed with the facility representative, Ashley Sanchez
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3