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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700744
Report Date: 08/12/2021
Date Signed: 08/12/2021 04:00:36 PM

Document Has Been Signed on 08/12/2021 04:00 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:PRIMARY SCHOOL-BAY AREA, THEFACILITY NUMBER:
015700744
ADMINISTRATOR:PLETZ, ASHLEYFACILITY TYPE:
850
ADDRESS:750 FARGO AVENUETELEPHONE:
(773) 870-1607
CITY:SAN LEANDROSTATE: CAZIP CODE:
94579
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/12/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Ashley PletzTIME COMPLETED:
04:20 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 on today's date, 8/12/2021 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met with Applicant/Director, Ashley Pletz and Director of Operations, Mia Lopez. The applicant has submitted an application for a PRESCHOOL license for 48 preschool aged children. The program will operate from 7:30AM-5:00PM, Monday through Friday, in 3 classrooms. Facility resides on the backside of Lewelling Campus. A health and safety inspection was conducted inside and outside and the measurements for the preschool are as follows:

INDOORS: 2441.62 square feet = 70 children
OUTDOORS: 27307.50 square feet = 364 children

The preschool rooms are equipped with varied age appropriate materials and equipment. There are 4 toilets, 3 urinals and 8 sinks available for children. Staff toilet is located in the main campus building nearest the Multi-Purpose Room. The kitchen is located in the MPR building. Facility will provide Lunch and AM/PM snacks with a menu posted for an authorized representative to see. The Director's office and Lewelling Campus bathroom will serve as isolation areas for sick children.

This facility plans to provide Individual Medical Services – IMS. A Plan of Operation that includes IMS must be submitted to the Department when any changes are made. 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.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2021
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 2
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: PRIMARY SCHOOL-BAY AREA, THE
FACILITY NUMBER: 015700744
VISIT DATE: 08/12/2021
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
The inside play yard is fenced in all around. The small climbing structures are cushioned to absorb a fall. Building overhang and tents provide sufficient shade in the play yard. Children bring water bottles from home and pitchers and cups as needed for indoor and outdoor activities. No cleaning agents were found stored with food. First aid supplies are available in the center. There is a working telephone on site. Carbon monoxide detector is is available and operable. Paper sign in/out sheets will be utilized and there is ample space for an authorized representatives full legal signature and records the time and date.

Ashley Pletz is a fully qualified preschool director and has completed 16 hours of health and safety training including pediatric CPR and First Aid.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and the director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

Zero Tolerance policies were explained. The center was found to be clean, safe, sanitary, and in good repair.

A license for 48 preschool aged children operating out of 3 classrooms (404, 405, and 406 plus optional use of MPR for gross motor skills ONLY) will be issued pending receipt of approved fire clearance.

An exit interview was conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2