073408231-9-17-2024-52-CC-MPRE-D97U49-20240917151448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408231
Report Date: 09/17/2024
Date Signed: 09/17/2024 03:14:57 PM

Document Has Been Signed on 09/17/2024 03:14 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:	SRVUSD EARLY CHILDHOOD EDUCATION PP - LIVE OAK		FACILITY NUMBER:	073408231
ADMINISTRATOR/ DIRECTOR:	KATHLEEN WITT		FACILITY TYPE:	850
ADDRESS:	5151 SHERWOOD WAY		TELEPHONE:	(925) 803-3100
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94582
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 12	CENSUS: 12	DATE:	09/17/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:08 PM
MET WITH:	Facility Representative - Barbara Slarve		TIME VISIT/ INSPECTION COMPLETED:	03:13 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 9/17/2024 at 12:08pm Licensing Program Analyst (LPA) Morgan Pringle met with Facility Representative Barbara Slarve for an Unannounced Annual/Random Inspection. Present during LPAs inspection were twelve (12) preschool age children and two (2) additional staff members. This facility is a Title V school and operates in room K02 on the Live Oak Elementary School Campus. LPA toured one (1) classroom for a health and safety inspection. The facility operates from 11:40am – 3:00pm Monday, Tuesday, Thursday, and Friday and 12:00pm – 3:00pm on Wednesdays. The facility has ample age-appropriate materials in the classroom that were observed to be clean and in good condition. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. There are two (2) child height sinks and one (1) adult height sink. There is one (1) toilet in the classroom as well. The facility is allowed to use the toilet in room K03 if needed. All children have access to clean drinking water in the classroom. The classroom has a working smoke/carbon monoxide combination detector and a fully charged fire extinguisher. There is a separate staff bathroom on site as well. The facility does not have a lunch time and provides all snacks for the children. The children also do not nap at the facility but has provided space in the room for quite and rest if it is needed. The outside play yard is clean with ample age-appropriate materials for the children. The play structure is sturdy and anchored into the ground. The yard is fully fenced and has plenty of shade for the children. LPA did not observe any harmful or unattended bodies of water in or around the facility. The play yard is maintained by the school district and is shared with other classrooms. Page 1 of 4

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

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: SRVUSD EARLY CHILDHOOD EDUCATION PP - LIVE OAK	FACILITY NUMBER: 073408231
	VISIT DATE: 09/17/2024

NARRATIVE

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The facility is operating within their licensed capacity and is in ratio today. All required postings are made visible on the wall by the entrance door. All staff working have obtained a criminal record clearance, exemption, or transfer. Facility uses substitutes from the school district when needed. The fire/disaster drill log is complete with the last drill logged on 8/29/2024. A physical census of the children was taken and cross referenced with the sign-in and out logs. All children have been properly signed in by their parent or authorized representative. LPA obtained a sample of the children’s files, the staff files, and the facility files. All files were complete.

No deficiencies cited during LPAs 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. 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.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

LIC809 (FAS) - (06/04)

Page: 2 of 6

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: SRVUSD EARLY CHILDHOOD EDUCATION PP - LIVE OAK	FACILITY NUMBER: 073408231
	VISIT DATE: 09/17/2024

NARRATIVE

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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: 09/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

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: SRVUSD EARLY CHILDHOOD EDUCATION PP - LIVE OAK	FACILITY NUMBER: 073408231
	VISIT DATE: 09/17/2024

NARRATIVE

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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 Staff Barbara Slarve.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

LIC809 (FAS) - (06/04)

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