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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405628
Report Date: 10/22/2024
Date Signed: 10/22/2024 12:39:44 PM

Document Has Been Signed on 10/22/2024 12:39 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:SRVSACCA - KIDS COUNTRY AT QUAIL RUNFACILITY NUMBER:
073405628
ADMINISTRATOR/
DIRECTOR:		TRUONG, JONATHANFACILITY TYPE:
840
ADDRESS:4040 GOLDEN BAY AVE.TELEPHONE:
(925) 552-4488
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY: 174TOTAL ENROLLED CHILDREN: 116CENSUS: 6DATE:
10/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:42 AM
MET WITH:Facility StaffTIME VISIT/
INSPECTION COMPLETED:
12:37 PM
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On 10/22/2024 at 9:42am Licensing Program Analyst (LPA) Morgan Pringle met with Facility Staff for an unannounced annual/random inspection. There were six (6) school age children, and four (4) additional staff present during the inspection. Two (2) additional staff members arrived by 11:15am. The facility operates on the far-left side of the Quail Run Elementary School campus. Three (3) classrooms, room one (1), two (2), and three (3), were toured for a health and safety inspection. The facility operates from 6:30am – 6:30pm Monday – Friday.

The classrooms were observed to have ample age-appropriate materials for the children’s learning and play that were observed to be clean, properly stored and in proper working order. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. The two (2) children’s bathrooms were observed to be in proper working order and clean with three (3) toilets, one (1) urinal and four (4) sinks. There are separate staff bathrooms on site as well. All furniture was observed to be free from defects and in proper working order. The facility does not transport children and all children are picked up from Quail Run Elementary after school and walked over to the facility by a staff member. All children have access to clean drinking water in each classroom. There are multiple smoke detectors, carbon monoxide detectors, fire extinguishers, and first aid kits on site. There is also a snake enclosed in a terrarium in room three (3).

The kitchen was observed to be clean, well maintained, and free from defects. All food on site is properly labeled and stored. Facility only provides snacks for the children. When children are present all day, the children will bring their own lunch. All food that will be brought from the children’s home will be properly labeled and stored. All hazards and chemicals are kept separate from the food and made inaccessible to the children.
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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SRVSACCA - KIDS COUNTRY AT QUAIL RUN
FACILITY NUMBER: 073405628
VISIT DATE: 10/22/2024
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The play yard was observed to be clean with ample age-appropriate materials for the children. The facility has a private fenced yard and shares the main play yard with the elementary school. The main yard is not fenced, and facility staff have full supervision when children are outside. There is plenty of shade and the play structure has ample cushion for extra safety. LPA did not observe any harmful or unattended bodies of water in or around the facility.

The facility is operating within its licensed capacity is in ratio. All staff working at the facility have obtained a criminal record clearance, exemption, or have transferred their clearances or exemption. The fire/disaster drill log is complete with the last drill logged 10/15/2024. A physical census of the children was taken and cross referenced with the sign-in and out log. All children have been signed in by their authorized representative or facility staff. LPA observed all required postings are made visible by the facility entrance. LPA obtained a sample of the children’s files, staff files, and the facility files. All files reviewed were complete.

No deficiencies cited during LPA’s inspection.

Licensee was reminded that California law requires facilities to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, facilities must submit the Unusual Incident/Injury form (LIC 624) to the Department. Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Personnel and facility roster must be properly maintained, and fire/disaster drills must be conducted at least every six (6) months and documented. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
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: SRVSACCA - KIDS COUNTRY AT QUAIL RUN
FACILITY NUMBER: 073405628
VISIT DATE: 10/22/2024
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For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-care-centers/.

Director was reminded that all adults 18 and over, 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.

Director was informed of the MyChildCarePlan.org website; 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.

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 platforms. 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.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
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: SRVSACCA - KIDS COUNTRY AT QUAIL RUN
FACILITY NUMBER: 073405628
VISIT DATE: 10/22/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility Director Jonathan Truong.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC809 (FAS) - (06/04)
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