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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407418
Report Date: 05/03/2023
Date Signed: 05/03/2023 05:01:28 PM


Document Has Been Signed on 05/03/2023 05:01 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:PANACHE ENFANTSFACILITY NUMBER:
073407418
ADMINISTRATOR:HOGUE, ALYSSAFACILITY TYPE:
850
ADDRESS:2410 SAN RAMON VALLEY BLVD#100TELEPHONE:
(925) 549-2239
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY:60CENSUS: 32DATE:
05/03/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:37 AM
MET WITH:Stefanie GalvezTIME COMPLETED:
04:40 PM
NARRATIVE
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On 5/3/2023 at 9:37am Licensing program analyst Morgan Pringle met with incoming Director Stefanie Galvez for a 10-day complaint visit for a complaint that was filed against the facility. During LPA's visit there were thirty-two (32) preschool children and four (4) staff present. The facility is dual licensed and holds a license for infants (073407419). LPA toured three rooms (Catapillars/Butterflies, Frogs and Tadpoles).

At 10:35am LPA conducted file reviews and it was found that one (1) staff (S3) member did not have a cleared criminal record clearance. LPA Pringle contacted the Oakland South East Child Care office for verification and it was confirmed that the staff member had not yet obtained the full clearance. LPA informed incoming Director that S3 must not be present at the facility until a criminal record clearance is obtained.

Deficiencies Cited
  • S3 did not obtain a criminal record clearance



LPA Pringle informed incoming Director that this report dated 5/3/2023 document(s) 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Pringle informed the Director to provide a copy of this licensing report dated 5/3/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan PringleTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
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: PANACHE ENFANTS
FACILITY NUMBER: 073407418
VISIT DATE: 05/03/2023
NARRATIVE
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An immediate $500 civil penalty is assessed today and $100 per day will be assessed until corrected.


A notice of site visit was given to licensee and must be posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Stefanie Galvez.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan PringleTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/03/2023 05:01 PM - It Cannot Be Edited

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: PANACHE ENFANTS
FACILITY NUMBER: 073407418

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/04/2023
Section Cited

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(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or...
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Staff must not return to the facility until clearance is obtained. Licensee is to review the regulations on criminal clearance and write a summary detailing what is needed prior to being in the facility for staff and volunteers. Then submit the summary to CCLD by POC date.
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This requirement is not met as evidenced by: base on record review it was found that Vichelle Nelson has not obtaind a criminal record clearance which poses an immediate risk to the health and safety of the children in care.
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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: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan PringleTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
LIC809 (FAS) - (06/04)
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