015700608-5-23-2023-52-CC-MOTI-CS4QE4-20230523120543

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700608
Report Date: 05/23/2023
Date Signed: 05/23/2023 12:06:03 PM

Document Has Been Signed on 05/23/2023 12:06 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 BRANCH COMMUNITY SCHOOL, THE		FACILITY NUMBER:	015700608
ADMINISTRATOR:	EISENMANN, LAUREN		FACILITY TYPE:	850
ADDRESS:	1893 N. VASCO ROAD		TELEPHONE:	(925) 478-9520
CITY:	LIVERMORE	STATE: CA	ZIP CODE:	94551
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 0	DATE:	05/23/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:33 AM
MET WITH:	Lauren Eisenmann & Lindsey Dale		TIME COMPLETED:	12:10 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	A Prelicensing inspection was conducted today 5/23/2023 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met with Applicants, Lauren Eisenmann and Lindsey Dale. The applicants have submitted a NEW application for a PRESCHOOL license for 30 preschoolers. The program will operate from 7:30 AM - 6:00 PM, Monday through Friday, in 4 classrooms. This facility consists of 1 building. Facility resides on the site Unitarian Universalist Church in Livermore. The facility will operate out of the Starr king Building. Parents will enter through Room 1A of the Starr king Building. A health and safety inspection was conducted inside and outside and the measurements were pulled from a previous visit and are as follows: INDOORS: 1048.62 square feet = 30 children OUTDOORS: 3635.05 square feet = 48 children The center has obtained an approved fire inspection clearance from the Livermore-Pleasanton Fire Department on 5/9/2023. The rooms are equipped with varied age appropriate materials and equipment. There are 2 toilets and 3 sinks available for children use. There are staff toilets located in the adjacent building. Facility will provide AM/PM snacks and lunch for the children. Menu will be posted at least one week in advance in a place visible for the authorized representative to see. Facility will utilize the Resting Room and staff bathroom for children who fall ill while in care. Mats were observed today.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

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 BRANCH COMMUNITY SCHOOL, THE	FACILITY NUMBER: 015700608
	VISIT DATE: 05/23/2023

NARRATIVE

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This facility plans to provide Incidental Medical Services - IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

There is a play yard for children and is fenced in all around. Tarp covering, building overhang and trees provide sufficient shade in the play yards. The center has water dispensers to provide clean drinking water inside and outside, with children bringing their water bottles from home. No cleaning agents were found stored with food. There is a refrigerator available. First aid supplies are available in the center. There is a working telephone on site. Facility utilizes a sign in/out sheet that allows enough space to record the date/time and full legal signature of authorized representative.

Lauren Eisenmann is a fully qualified preschool director. 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant 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 applicant 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.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

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 BRANCH COMMUNITY SCHOOL, THE	FACILITY NUMBER: 015700608
	VISIT DATE: 05/23/2023

NARRATIVE

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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.

A license for 30 preschool children, will be issued effective today, 05/23/2023.

Exit interview conducted with Applicants, Lauren Eisenmann and Lindsey Dale.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

LIC809 (FAS) - (06/04)

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