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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400470
Report Date: 11/01/2024
Date Signed: 11/01/2024 02:39:55 PM

Document Has Been Signed on 11/01/2024 02:39 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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LOS ALTOS UNITED METHODIST CHURCH CC.FACILITY NUMBER:
434400470
ADMINISTRATOR/
DIRECTOR:
DENIZE GRAYFACILITY TYPE:
850
ADDRESS:655 MAGDALENA AVENUETELEPHONE:
(650) 941-5411
CITY:LOS ALTOSSTATE: CAZIP CODE:
94024
CAPACITY: 140TOTAL ENROLLED CHILDREN: 140CENSUS: 65DATE:
11/01/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:05 PM
MET WITH:Denize GrayTIME VISIT/
INSPECTION COMPLETED:
03:05 PM
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On November 1, 2024 at 12:05 PM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced Annual Random Inspection and met with the facility representative Denize Gray. LPA disclosed the purpose of the inspection and was granted entry into the facility by the facility representative. There were 65 preschool age children present during this inspection and 13 additional staff members. The facility consists of five classrooms. The facility was toured inside and out for a health and safety inspection. The hours of operation are 8:00 AM-3:30 PM, Monday -Friday

LPA checked the facility RECORDS and they show all individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. LPA conducted a census of the children and the census matches the children signed in on the sign in sheet. LPA reviewed five (5) children's files and three (3) staff files around 12:30 PM. All staff files have required Health Screening, and Employee Rights forms, and all children files contains Personal Rights, Medical Consent forms, and Identification & Emergency Information. At least one opening/ closing staff member has a current CPR & First Aid Certificate.

The five (5) classrooms were inspected around 12:15 PM, and teacher child ratio was observed. There are adequate play and learning materials available. The floors are well maintained and the furniture is the correct size for preschool children. The classrooms equipment is in good repair and the room temperature is adequate for children in care. There is proper individual storage space for each child and the cubbies have their names posted on the shelves. The isolation area for sick children is the resource office, away from other children in care.

LPA tested the centers carbon monoxide detector in the cafeteria area and found it to be functioning properly. The centers smokes detectors are wired to notify the fire department when triggered. Per Director, the smoke detectors are fully functional and serviced regularly. The center also have a working telephone, pull down fire alarm system, and multiple fully charged 3A40BC fire extinguishers, which meets standards established by the State Fire Marshal hanging in each classroom on the walls. Disaster drills are being conducted at least once every 6 months and the last one conducted was on 10/25/24. All required documents are posted in a public accessible area.

See 809-C.
Chandra CharlesTELEPHONE: (510) 286-0966
Elimika WoodsTELEPHONE: (510) 622-2550
DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LOS ALTOS UNITED METHODIST CHURCH CC.
FACILITY NUMBER: 434400470
VISIT DATE: 11/01/2024
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This facility provides morning and afternoon snacks for children in care and there are weekly menus posted at the facility. LPA observed an area where they have a refrigerator this area is clean and free of evidence of rodents. LPA reminded the facility representative that all persons engaged in food preparation and service shall observe personal hygiene and food service sanitation practices to protect food from contamination. Food/beverages capable of rapid spoiling are properly stored. All storage containers for solid waste have tight fitting covers that are in good repair.

LPA’s observations during the visit...at 1:00 PM, LPA observed children playing outdoors on the playground with each other. There were two teachers on the yard watching the children run, slide, and climb on the different structures. The teachers were positioned with their backs to the walls which gave them the best views to watch children at play. One staff member had a microphone device that helped the children hear her directions from all over the yard.

The outdoor area has a play structure with a slide that has cushioning underneath to absorb children falls that's anchored to the ground, a play house, and a spinning round-about. There are multiple canopies that provides shade to children while at play. The play equipment is age appropriate and in good repair. The outdoor play area is fully fenced and free of defects and dangerous condition. There are multiple sheds with locks to prevent children access to equipment on the playground.



LPA checked the staff bathroom around 1:15 PM, and was told by the representative it was separate from the children’s bathroom. The children's bathrooms are located in the classrooms. LPA checked and flushed all of the toilets in each bathroom to see if they were working, and ran the water in the faucet to make sure the temperature did not get too hot for children. LPA Woods confirmed that all of the sinks, toilets, and faucets are in safe and sanitary operating condition during todays inspection.

California Law requires Child Care Centers licensees 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 electronic mail. The facility representative was also reminded 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 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-carecenters/.



See 809-C
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LOS ALTOS UNITED METHODIST CHURCH CC.
FACILITY NUMBER: 434400470
VISIT DATE: 11/01/2024
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LPA reminded the facility representative that a refrigerator shall be used to store any medications that requires refrigeration. The center is equipped with fully stocked first aid kits that are available in the classrooms.

Lead Testing – Child Care Centers (CCC) CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: 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 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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.

The facility representative 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.

The facility representative 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.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Denize Gray.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024
LIC809 (FAS) - (06/04)
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