Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407392
Report Date: 09/24/2018
Date Signed: 09/24/2018 10:21:50 AM

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:PUSD - HIGHLANDS PRESCHOOLFACILITY NUMBER:
073407392
ADMINISTRATOR:HOLMAN, LONGRELFACILITY TYPE:
850
ADDRESS:4141 HARBOR STTELEPHONE:
(925) 473-2440
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY:24CENSUS: 22DATE:
09/24/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:LAURA SERRATOTIME COMPLETED:
10:30 AM
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LPA Tasha Alexander met today with Head Teacher Laura Serrato for an unannounced ANNUAL/RANDOM inspection. LPA toured the facility and play yard for a health and safety inspection. A review of staff records on 9/24/18 indicates that all facility staff is background checked by the PUSD school district. Personnel files were reviewed. The teacher/child ratio was being met. Children's files were reviewed. The classroom(s) and play yard were age appropriate and in good repair. Bathroom is clean and in working order. Breakfast and lunches are provided by the elementary school. The cafeteria area was maintained in a clean manner. There is an adequate variety and quantity of food available; menu was posted. The sign in and out logs were reviewed. All posting requirements are being met. Outdoor play area was free of hazards and provided a shaded area for the children and access to drinking water. Medications, when dispensed, are stored in the locked classroom cabinet in a locked box. There is a working telephone at the facility. Opening and closing staff have current CPR and 1st Aid training 3/14/18 respectively.

Effective September 1, 2016, a person may not work or volunteer at a child care center or family child care home unless he or she has been vaccinated against pertussis, measles and influenza or has an exemption.
Today all staff have immunization records in file.

The newly implemented mandatory mandated reporter training course was also discussed today.
Today all staff have certificates of completion in file. Completed 8/2018

Applicant was instructed on the law establishing a $100 fine per day for adults who are providing care who do not have fingerprint clearances.
CONTINUED ON 809-C

SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2018
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: PUSD - HIGHLANDS PRESCHOOL
FACILITY NUMBER: 073407392
VISIT DATE: 09/24/2018
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

As a result of this visit, there are no deficiencies cited. This report must be available for public review for 3 years. An exit interview was conducted and a site visit notice was posted.

SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2018
LIC809 (FAS) - (06/04)
Page: 2 of 2