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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010205821
Report Date: 04/23/2024
Date Signed: 04/23/2024 02:54:05 PM

Document Has Been Signed on 04/23/2024 02:54 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:VALLEY CHRISTIAN PRESCHOOLFACILITY NUMBER:
010205821
ADMINISTRATOR/
DIRECTOR:		JARIN, RINAFACILITY TYPE:
850
ADDRESS:7500 INSPIRATION DRIVETELEPHONE:
(925) 560-6235
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 132TOTAL ENROLLED CHILDREN: 132CENSUS: 83DATE:
04/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:05 PM
MET WITH:Director, Rina Jarin TIME VISIT/
INSPECTION COMPLETED:
03:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Saini met with Director Rina Jarin for an unannounced case management inspection in response to an Unusual Incident that the Facility self reported to the Department on 04/18/2024.
LPA Saini conducted interviews with the center director and staff and obtained documents. Based on the interviews and record reviews, the Facility acknowledged that during the transition from the classrooms to the playground, a preschooler (C1) was left unattended in the bathroom for approximately 5 minutes. The staff failed to complete the name-to-face roll call or sweep the classroom/ bathroom before leaving, concludes that the staff did not provide adequate supervision to the children in care. California Code of Regulations, {Title 22, Division & Chapter Number 101229(a)(1)} is being cited on the attached LIC 809D. The teacher in question has been terminated effective 04/19/2024.

LICENSEE MUST POST ANY TYPE A DEFICIENCIES DURING TODAYS VISIT WITH THE NOTICE AND LICENSEE UNDERSTANDS THE NOTICE AND TYPE A DEFICIENCIES MUST REMAIN POSTED FOR THIRTY DAYS. REQUIREMENTS FOR THE AB 633 FACT SHEET AND A COPY OF THE ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) WERE DISCUSSED WITH THE PROVIDER. PROVIDER UNDERSTANDS THIS REQUIREMENT.

An immediate civil penalty of 500$ is assessed today.

An exit interview was conducted with the director, Rina Jarin.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2024
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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Document Has Been Signed on 04/23/2024 02:54 PM - It Cannot Be Edited


Created By: Jyoti Saini On 04/23/2024 at 02:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: VALLEY CHRISTIAN PRESCHOOL
FACILITY NUMBER: 010205821

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/24/2024
Section Cited
CCR
101229(a)(1)

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101229(a)(1)Responsibility for Providing Care and Supervision:(a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation
This requirement is not met as evidence by:
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The facility has already conducted in-house training on care and supervision. During the inspection, LPA received a copy of the training provided to the staff. The director also submitted a written plan to the LPA on how the facility and staff will ensure complete supervision of all children in care.
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Based on the interviews and record reviews, the facility did not comply with the section cited above. (C1) was left unattended in the bathroom for approximately 5 minutes, which poses an immediate health and safety risk to children in care.
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An immediate civil penalty of 500$ is assessed today

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Wynn Norona
LICENSING EVALUATOR NAME:Jyoti Saini
LICENSING EVALUATOR SIGNATURE:
DATE: 04/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024


LIC809 (FAS) - (06/04)
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