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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070210519
Report Date: 12/20/2022
Date Signed: 12/20/2022 12:18:38 PM

Document Has Been Signed on 12/20/2022 12:18 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:CLAYTON COMMUNITY SCHOOLFACILITY NUMBER:
070210519
ADMINISTRATOR:NANCY HALEYFACILITY TYPE:
840
ADDRESS:5880 MT. ZION DRIVETELEPHONE:
(925) 672-0388
CITY:CLAYTONSTATE: CAZIP CODE:
94517
CAPACITY: 170TOTAL ENROLLED CHILDREN: 170CENSUS: 0DATE:
12/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Jacklyn DeBeaumont TIME COMPLETED:
12:15 PM
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On 12/20/22, Licensing Program Analysts (LPAs) Melissa Guirit and Melissa Domantay met with Preschool Teacher, Jacklyn DeBeaumont for a Required 1 Year inspection. Per teacher, Director, is on vacation and Asst. Director would be here around 11:00 AM. Also present during today's inspection were 4 staff. All adults present today are fingerprint cleared and associated. The center operates Monday through Friday from 6:45am to 5:30pm.

LPAs toured the classrooms with Teacher. The program operates in four classrooms. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. There is a separate staff bathroom. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers and were in good repair. LPAs observed multiple 3A40BC Fire extinguishers and smoke and Carbon Monoxide Detectors. The last Fire Drill was conducted on 12/8/2022. Facility is reminded that fire drills should be conducted at least every 6 months. The center is equipped with a fully stocked first aid Kit and working telephone. Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles. Facility’s License, Parents’ Rights Poster PUB 393, Personal Rights, and Activity Schedules were observed to be posted. Facility provides snacks for children. Isolation area for sick children will be in one of the empty classrooms.

Outdoor playground was inspected and observed to be safe and fully fenced. Facility is reminded that 100% supervision of children must be provided. All climbing equipment is properly anchored to the ground with adequate and appropriate cushioning under them.

See 809-C for continuance.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Melissa Guirit
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2022
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
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CLAYTON COMMUNITY SCHOOL
FACILITY NUMBER: 070210519
VISIT DATE: 12/20/2022
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The play equipment was maintained in good condition and free of hazards. Shade is provided by way of covered areas. There were no bodies of water observed during today's inspection. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

Children sign in and out procedures and logs were reviewed. Facility uses manual sign in/sign out procedure. LPAs reminded facility to maintain sign in/sign out procedures and make sure parents/authorized representatives sign the child in and out. Five children's files and four staff files were reviewed and contained required documents. Teacher, Jacklyn DeBeaumont and Asst. Director Michael Jacobus has valid CPR/First Aid Certificates that expires 05/2023. Children's Roster and staff personnel report was reviewed and copies were provided to LPAs.

On or before March 30, 2018 any person who works in a child care facility shall complete Mandated Reporter training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.Document Link Icon

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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)/ (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

Facility was reminded that all adults 18 and over, 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

There are no deficiencies cited today. Exit interview conducted and report was reviewed with Teahcer, Jacklyn DeBeaumont. A Notice of Site Visit was given and must remain posted for 30 consecutive days.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Melissa Guirit
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022
LIC809 (FAS) - (06/04)
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