073408865-7-26-2022-02-CC-MPRE-CGPVFD-20220726162346

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408865
Report Date: 07/26/2022
Date Signed: 07/26/2022 04:24:19 PM

Document Has Been Signed on 07/26/2022 04:24 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:	KIDDIE ACADEMY		FACILITY NUMBER:	073408865
ADMINISTRATOR:	KHARE,RISHU & KHARE,VIJAY		FACILITY TYPE:	830
ADDRESS:	1620 NERLOY RD.		TELEPHONE:	9252616717
CITY:	OAKLEY	STATE: CA	ZIP CODE:	94561
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 18	CENSUS: 13	DATE:	07/26/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Laronda Levias		TIME COMPLETED:	04:10 PM

NARRATIVE

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On 7/26/2022 at 10:00am Licensing Program Analyst’s (LPA’s) Morgan Pringle and Christina Watts met with Director Laronda Levias Mallory for an Unannounced Annual Inspection. There were thirteen (13) infants and four (4) other staff present during the inspection. The facility holds two (2) other licenses for a preschool and school age program (073408864, 073408866). The infant license has a toddler option attached as well. LPA’s toured two (2) classrooms, The Caterpillars and The Butterflies classrooms for a health and safety inspection. The Butterflies classroom is for the toddlers. The facilities operating hours are 6:30am – 6:30pm, Monday – Friday.

The facility has ample age appropriate materials in the classrooms that were observed to be clean and in good condition. All toxins, medications, cleaning products, and hazardous materials were observed to be in inaccessible areas. Both bathrooms are clean and in proper working order. All children have access to clean drinking water in and outside of the classroom. There is a working carbon monoxide detector and smoke detectors in the facility. The outside play yard is clean and free from hazards with plenty of shade. The outside play yard is fully fenced as well. LPA did not observe any harmful or unattended bodies of water in or around the facility.

The napping equipment is properly stored, clean and in good condition. Each child has their own crib or cot that is labeled. All infants have appropriate bedding and food/bottle storage. The diaper changing area is clean and free from defects. During LPA’s inspection, through record review it was found that there were six (6) expired Needs and Services Plan’s (See LIC9102TV) and three (3) missing Needs and Services Plans (See LIC9102TV).

The facility is operating within its licensed capacity and is in ratio. All proper postings are made visible by the entrance door of the facility. The kitchen is neat, clean and free from hazards. The facility provides all food for the children. All food provided by the facility is properly stored and labeled. The fire/disaster drill log was complete with the last drill logged 7/5/2022. Continued on LIC809-C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDDIE ACADEMY	FACILITY NUMBER: 073408865
	VISIT DATE: 07/26/2022

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A physical census of the children and staff were taken and cross referenced with the sign-in and out log. All children were properly signed in. All staff on site have obtained a criminal record clearance. LPA obtained the facilities files, children’s files and staff files. During LPA record review, two teachers were missing immunization records (See LIC9102TV).

Deficiencies cited during Inspection
· Two (2) teachers missing TB record & one (1) teacher missing Health Screening Report

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.

Director 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.

Continued on LIC809-C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDDIE ACADEMY	FACILITY NUMBER: 073408865
	VISIT DATE: 07/26/2022

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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

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

Exit interview conducted and report was reviewed with Director Laronda Levias Mallory

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/26/2022 04:24 PM - It Cannot Be Edited

Created By: Morgan Pringle On 07/26/2022 at 02:58 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: KIDDIE ACADEMY	FACILITY NUMBER: 073408865
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/26/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based onrecord review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/09/2022
	Plan of Correction
1 2 3 4	Director will ensure that both staff memebers complete a TB test or schedule an appointment with a physician. If TB teast and Health screen has been completed Director will make sure to obtain records. Upon completeion Director will send LPA a copy of the Report and the two missing TB record.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Jang

LICENSING EVALUATOR NAME:

Morgan Pringle

LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

LIC809 (FAS) - (06/04)

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