015700672-12-10-2024-52-CC-ASIS-DBTSTD-20241210130923

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700672
Report Date: 12/10/2024
Date Signed: 12/10/2024 01:09:30 PM

Document Has Been Signed on 12/10/2024 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	LEARN AND PLAY MONTESSORI PERALTA		FACILITY NUMBER:	015700672
ADMINISTRATOR/ DIRECTOR:	SHAWNNEN FRASIER		FACILITY TYPE:	860
ADDRESS:	4511 PERALTA BLVD		TELEPHONE:	(510) 916-1503
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY: 118	TOTAL ENROLLED CHILDREN: 118	CENSUS: 16	DATE:	12/10/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Natasha Aguilar		TIME VISIT/ INSPECTION COMPLETED:	12:00 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	Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Senior Director Natasha Aguilar for the purpose of a pre-licensing change of ownership inspection. Applicant requests a infant component for 8 infants ages 0-24 months, a toddler component for 24 toddlers ages 18-36 months, and a preschool component for 86 preschool children ages two years to entry into first grade for a total capacity of 118. The program will operate Monday through Friday from 8:00 a.m. to 6:00 p.m. The fire clearance was granted and received on 10/3/2024. The facility will provide morning and afternoon snacks. Lunch options are available through My Green Lunch. Parents will provide formula, breast milk, and baby food. LPA informed Senior Director that the facility will be converted to a single child care center license under facility number 015700672, therefore LPA will be closing the current preschool facility number 013422411. LPA reviewed with Senior Director the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. LPA discussed the safe sleep regulations with Senior Director 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 Senior Director 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. Report continues on LIC809-C page 2.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LEARN AND PLAY MONTESSORI PERALTA	FACILITY NUMBER: 015700672
	VISIT DATE: 12/10/2024

NARRATIVE

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INDOOR ACTIVITY SPACE:
There is one infant classroom located in Infant Classroom #1, two toddler classrooms located in Toddler Classrooms #2 & #4, and two preschool classrooms located in Preschool Classrooms #3 & #5/6. LPA observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. LPA observed the crib area was separated using shelving less than four feet tall. LPA informed Senior Director that the partition must be at least four feet. LPA informed Senior Director to submit photos of the new wall partition meeting the four foot requirement. There is a first aid kit in each of the classrooms. Medications will be stored in the office. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. No poisons or firearms on the premises. LPA observed water fountains in each of the classrooms. LPA observed a functional carbon monoxide detector in each classroom. LPA observed an electronic sign-in/sign-out system.

LPA measured the infant classroom #1. The total classroom space contains a total of 540 square feet, which will accommodate applicant's request for 8 infants. There are two sinks for the infants which is located within arms reach of a sink. LPA measured the toddler classrooms #2 & #4. The total classroom spaces contain a total of 1,301 square feet, which will accommodate applicant's request for 24 toddlers. Senior Director informed LPA that they would like to update the toddler capacity requested to 25. There are two sinks located in toddler classroom #2. LPA measured the preschool classrooms #3 & #5/6. The total classroom spaces contain a total of 2,016 square feet, which will only accommodate 57 preschool children. There are six toilets and four sinks for the children. There is an additional two sinks for the children located on Playground A. There are two separate private restrooms for the staff located down the hallway. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There are two outdoor areas on the property, Preschool Playground A and Infant/Toddler Playground B. Playground A is fenced with a wooden fence that is at least four feet tall and Playground B is fenced with a wrought iron fence that is at least four feet tall. LPA observed a sufficient amount of equipment and toys. There is a play structure located on Playground A which includes a safety label designated use for children 2 to 5 years old. There are no bodies of water on the premises. There are shaded areas supplied by trees and overhangs

Report continues on LIC809-C page 3.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LEARN AND PLAY MONTESSORI PERALTA	FACILITY NUMBER: 015700672
	VISIT DATE: 12/10/2024

NARRATIVE

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LPA measured Preschool Playground A. The outdoor play area contains a total of 3,268 square feet, which will only accommodate 43 preschool children. LPA measured the Infant/Toddler Playground B. The outdoor play area contains a total of 753 square feet, which will only accommodate 10 toddlers. Applicant will request an Insufficient Outdoor Space Waiver for both yards and Shared Outdoor Space Waiver for infants and toddlers. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

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

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 Senior Director 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.

Senior Director 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.

Senior Director 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.

Report continues on LIC809-C page 4.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LEARN AND PLAY MONTESSORI PERALTA	FACILITY NUMBER: 015700672
	VISIT DATE: 12/10/2024

NARRATIVE

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Written Directives for Lead Testing in Child Care Centers: Assembly Bill 2370, Chapter 676, Statutes of 2018, added Health and Safety Code section 1597.16 requiring all licensed Child Care Centers constructed before January 1, 2010, test their water for lead between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first lead testing. For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

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.

Exit interview conducted and report was reviewed with Senior Director Natasha Aguilar.

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

1. Shared Outdoor Space Waiver for Infant and Toddler Playground.

2. Insufficient Outdoor Space Waiver for Toddler Playground and Preschool Playground.

3. Proof of crib wall partition.

4. Amended fire clearance (STD850).

5. Pending documents.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

LIC809 (FAS) - (06/04)

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