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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010200356
Report Date: 05/10/2023
Date Signed: 05/10/2023 03:43:49 PM

Document Has Been Signed on 05/10/2023 03:43 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 KAMPUS COOPERATIVE PLAY SCHOOLFACILITY NUMBER:
010200356
ADMINISTRATOR:CARNAHAN, MICHELLEFACILITY TYPE:
850
ADDRESS:1711 - 2ND STREETTELEPHONE:
(510) 521-1218
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY: 24TOTAL ENROLLED CHILDREN: 29CENSUS: 19DATE:
05/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Lori WhittockTIME COMPLETED:
04:00 PM
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On 05/10/2023 at 1:20pm, Licensing Program Analyst (LPA) Catherine Fernandes met with Assistant Director for an Unannounced Required Annual Inspection. There were 19 preschool age children, two Directors/teachers and five parent volunteers. The teacher- child ratio was being met today. The center was toured for a health and safety inspection. The facility operates from Monday through Friday from 9:00am–2:15pm.

The center operates in the Woodstcok Homes Corporation building and consist of one main classroom. The room floors, surfaces, furniture and equipment appear to be safe, sanitary and in good repair. The heating, lighting and ventilation is adequate. There is a total of two toilets, one urinal and three sinks available for the children which are sanitary and in operational conditions. There are supplies available for the children to wash and dry their hands. There is a separate stall for staff and parents. The activities and toys appear to be age appropriate for the children in care. The outside play area is fully fenced with shaded areas for the children. There is play structure that is sturdy and anchored into the ground, there are wood chips for cushioning to absorb the impact from a fall. LPA did not observe any bodies of water, free standing water, cleaning supplies, or toxic items accessible to children during today’s inspection. Lunches and snacks are brought from home however if a child forgets to bring a lunch there is food available at the center. The kitchen area was maintained in a clean manner. The children have their own hooks outside to store personal belongings. All the children have personal water bottles, access to clean drinking water and teachers have a pitcher of water in the classroom that is brought outside while outdoors. The center has conducted their lead testing and has provided proof of the corrected lead requirement for preschools. The fire system is a pull station that is located near the front door, there is a working smoke detector near the bathrooms. A working carbon monoxide detector located above the doorway leading to the kitchen and two fully charged fire extinguisher.


All proper postings are made visible by the front of the center’s entrance. The fire/disaster drill log was complete with the last drill logged 2/8/23. A physical census of the children and staff were taken and cross referenced with the electronic sign-in and out log. All children were accounted for and properly signed in. LPA reviewed the electronic facilities’ files and reviewed five children’s files, two staff files and three parent volunteers. LPA obtained a copy of the children’s roster. Report continued on 809C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
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 KAMPUS COOPERATIVE PLAY SCHOOL
FACILITY NUMBER: 010200356
VISIT DATE: 05/10/2023
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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, however NO IMS is being provided as of today’s date. 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.

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.

No citations were issued during todays inspection.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and reviewed with the Directors

Report and Appeal Rights provided

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
LIC809 (FAS) - (06/04)
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