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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070209024
Report Date: 10/12/2022
Date Signed: 10/12/2022 01:24:03 PM

Document Has Been Signed on 10/12/2022 01:24 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ACORN LEARNING CENTERFACILITY NUMBER:
070209024
ADMINISTRATOR:GONZALES, ANNAFACILITY TYPE:
850
ADDRESS:816 DIABLO ROADTELEPHONE:
(925) 837-1145
CITY:DANVILLESTATE: CAZIP CODE:
94526
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 53DATE:
10/12/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Anna GonzalesTIME COMPLETED:
01:25 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 10/12/22 at 11:30AM, Licensing Program Analyst (LPA) Catherine Fernandes arrived announced a case management inspection and met with Director Anna Gonzales. The center is a combination center with a maximum capacity of 66 children. There were 53 preschoolers in care with an additional seven staff members.

The purpose of the visit was a result of receiving an unusual incident report dated 8/29/22. An incident occurred where a child was complaining of arm pain after a teacher sat her/him down at the table. The Director Gonzales assessed the injury and contacted the child's parent. The child received medical attention and came back to the center the same day.

The attached type B deficiency is being cited today and must be corrected by the due date.


An exit interview was conducted
Report, Notice of site visit and Appeals Rights provided


SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/12/2022
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
Document Has Been Signed on 10/12/2022 01:24 PM - It Cannot Be Edited


Created By: Catherine Fernandes On 10/12/2022 at 01:06 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: ACORN LEARNING CENTER
FACILITY NUMBER: 070209024

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/02/2022
Section Cited
CCR
101223(a)

1
2
3
4
5
6
7
Personal Rights- The licensee shall ensure that each child is accorded the following personal rights: To be accorded dignity in his/her personal relationships with staff and other persons. To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement has not been met:
1
2
3
4
5
6
7
Center will conduct a staff meeting regarding personal rights. Then send a copy of an agenda of what will be discussed, who will attend and when the training will take place to CCLD by POC date.
8
9
10
11
12
13
14
Based on interviews and the report submitted to Licensing a child sustained an injury while in care, which is a potential safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Mayla Mendoza
LICENSING EVALUATOR NAME:Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2022


LIC809 (FAS) - (06/04)
Page: 2 of 2