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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408918
Report Date: 05/11/2022
Date Signed: 05/11/2022 02:58:08 PM

Document Has Been Signed on 05/11/2022 02:58 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:KID TIME, INC.FACILITY NUMBER:
073408918
ADMINISTRATOR:CASWELL, ANGELAFACILITY TYPE:
830
ADDRESS:2551 PLEASANT HILL ROADTELEPHONE:
(925) 930-6550
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 3DATE:
05/11/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Angela CaswellTIME COMPLETED:
01:45 PM
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On 5/11/22 at 12:15 pm Licensing Program Analysts (LPAs) Monica Mathur and Christina Watts conducted an unannounced Plan of Correction (POC) inspection at Kid Time, Inc. - infant program. Director, Angela Caswell was not present and LPAs met with staff.
Purpose of inspection is to observe corrections and changes made since facility was cited Type A during complaint investigation on 5/9/22.

LPAs observed all infant feeding bottles were labeled on the top cap and bottom portion with child's name. Observed reminders are posted near refrigerator and cabinets to ensure all infant food is properly labeled. Director submitted plan of correction written statement outlining how facility will train staff and ensure mix ups do not happen again.

Director arrived in facility around 12:40 pm. LPAs reviewed files and Director stated most parents have been given complaint report of 5/9/22 and signed Statement Acknowledging Receipt of Licensing Reports LIC9224. Some parents are yet to be given when their child is back in attendance.

Deficiency of 5/9/22 is cleared by visit and Letter of Clearance was given to Director. No deficiencies were issued today. This report was reviewed with Director, Angela Caswell. NOTICE OF SITE VISIT WAS ISSUED, TO BE POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/11/2022
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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