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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408875
Report Date: 09/17/2024
Date Signed: 09/17/2024 04:06:27 PM

Document Has Been Signed on 09/17/2024 04:06 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CALVARY CHRISTIAN PRESCHOOLFACILITY NUMBER:
073408875
ADMINISTRATOR/
DIRECTOR:		MULLENS, AMYFACILITY TYPE:
830
ADDRESS:3425 CONCORD BLVDTELEPHONE:
(925) 682-6728
CITY:CONCORDSTATE: CAZIP CODE:
94519
CAPACITY: 6TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
09/17/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Cassie Grayson and Arlene McleanTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On September 17, 2024, Licensing Program Analyst, (LPA) M. Domantay met with Administrator, Cassie Grayson and Director, Arlene Mclean, for the purpose of an unannounced case management inspection for an application that was submitted for a change of capacity, increase and name change. Facility is requesting to increase infant program capacity to 12 infant children and adding a new infant classroom, classroom B (teddy classroom) to the infant program license. Facility is also requesting a name change. Facility operates Monday through Friday from 7:00 AM to 6:00 PM. The fire clearance was granted on 1/10/2024 by the Contra Costa County Fire Protection Department for 12 infants 0-24 months. LPA toured the infant indoor and outdoor infant areas with Administrator, Cassie Grayson.

INDOOR ACTIVITY SPACE:
There are 2 infant areas designated for the infant program: classroom A (jungle cubs classroom) and classroom B (teddy bear classroom). LPA observed 4 cribs in each classroom. Applicant plans to care for 8 crib aged infants. The changing tables in the infant classrooms is in hands reach of a sink. LPA observed a sufficient amount of equipment, toys, tables, cots, and chairs. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. LPA observed a combination smoke/carbon monoxide detector in the preschool classroom. LPA observed 2 sinks and 1 toilet in classroom B and 1 sink in classroom A for the infant program. LPA observed a manual sign-in/sign-out system. There is a separate private restroom for the staff located on the facility. Children who become ill during the day will be isolated in the Director's office with a cot and will use the staff restroom, if necessary.

LPA measured all classrooms/areas for the infant program. The total classroom space for the infant classroom contains a total of 486.27 square feet, which will accommodate Applicant's request for 12 infant children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

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SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
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)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CALVARY CHRISTIAN PRESCHOOL
FACILITY NUMBER: 073408875
VISIT DATE: 09/17/2024
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OUTDOOR ACTIVITY SPACE:
LPA notified Applicant each program on site (infant, toddler, and preschool) should have their own outdoor space. Per Applicant, infant yard will be renovated to ensure infants have a separate outdoor space from toddler and preschool program. LPA notified Applicant that sufficient barriers, cushioning and shading should be installed in the infant play yard. The outdoor play area is fenced with chain linked fencing that is at least four feet tall. LPA notified Applicant additional equipment and toys that is age appropriate is needed for infant outdoor play. Per Applicant, she will notify LPA once facility has completed infant outdoor play yard renovations in order for LPA to conduct additional inspection to measure outdoor infant play yard. There is no play structure present in the infant outdoor play yard area during today's inspection. There are no bodies of water on the premises. LPA notified Director that all water tables must be emptied after every use.

LPA discussed 100% supervision is always required in all areas that children have access to including the
bathroom. Personal Rights, inspection authority, reporting requirements, maintaining buildings and grounds
was reviewed. Staff Qualifications, Staff to Children’s ratios and Capacity was explained to ensure
compliance. LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director’s absence must be reported to the department within 10 working days.

Applicant was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare 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: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CALVARY CHRISTIAN PRESCHOOL
FACILITY NUMBER: 073408875
VISIT DATE: 09/17/2024
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Exit interview conducted and report was reviewed with Director, Arlene Mclean.

The following items are required before a license will be issued:

1. Licensing Program Manager (LPM) final file review.

2. Applicant must provide infant program a separate outdoor play yard from the toddler and preschool program and ensure there is 75 square feet per child.

3. Applicant must provide sufficient age appropriate furniture and equipment, barriers, cushioning, and shading in the infant outdoor play yard.

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SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
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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