<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010211015
Report Date: 11/03/2023
Date Signed: 11/03/2023 02:20:20 PM

Document Has Been Signed on 11/03/2023 02:20 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:LIVERMORE PLAYSCHOOLFACILITY NUMBER:
010211015
ADMINISTRATOR:ZAPIEN, ROBYNFACILITY TYPE:
850
ADDRESS:5261 EAST AVENUETELEPHONE:
(925) 447-6042
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 57DATE:
11/03/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Robyn ZapienTIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On November 3, 2023, Licensing Program Analyst (LPA) Simerjit Kaur arrived to conduct UNANNOUNCED RANDOM REQUIRED SITE INSPECTION for Preschool age program and met with Director Robyn Zapien. Present during the inspection are 57 preschool age children and 9 fingerprint cleared staff members. The facility was toured for a health and safety inspection. The hours of operation are Monday through Friday, 7:00am to 6:00 pm.

The facility has three buildings and the main (first) building is being utilized for the School Age and preschool age program. The second building is for 2's classroom, and third/last building is for 3's/4's classroom for preschool age component. The main building also utilizes for Junior K's classroom during morning 8:45 am-1:15pm. There are 2 combined bathrooms for boys and girls, and staff bathroom in the main building. The second building and third building classrooms have operable toilets and facets. The facility has adequate heating and lighting. There is running water, soap, and paper towels available for children to wash and dry their hands.
The center does provide morning/afternoon snacks and lunch. The menu is posted in each classroom. There is drinking water readily available to children indoors and outdoors. The kitchen/food preparation and storage areas appear to be clean and free of evidence of rodents, and food is protected against contamination. Disinfectants, cleaning solutions poisons and other items that are dangerous to children were inaccessible during the inspection today. The center is equipped with working telephone, carbon monoxide detector, pull down fire alarm and fire extinguishers. The alarm system is tested by Bay Alarm Company. There are no pools or similar bodies of water at this facility. The floors were free of tripping hazards during today's inspection. The storage containers for solid waste have tight-fitting covers. The classrooms are equipped with age appropriate tables and chairs. There is adequate storage for children's belongings. There are school materials and art supplies stored in the storage cabinet. There are two separate outdoor playgrounds (upper and lower playground). Outdoor activity spaces and playground equipment was observed to be safe during today's inspection.

Continued on LIC 809C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: LIVERMORE PLAYSCHOOL
FACILITY NUMBER: 010211015
VISIT DATE: 11/03/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
There is cushioning underneath the anchored play structure. The outdoor play space between main building and third building (the upper playground) is rotated with school age component. The center is in compliance with the sign in and out procedure. Children and staff records were reviewed and contained required licensing documents.

All required documents are posted for public review. LPA reviewed and obtained facility roster. Teachers present today meet the qualification requirements. The Staff members have current CPR/First Aid certificate and have current mandated reporter training. LPA reviewed staff and file qualified teachers. The facility also has conducted and documented fire/earthquake/disaster drill training on 9/2/23.

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Personnel and facility roster must be properly maintained, and fire/disaster drills must be conducted at least every six (6) months and documented. Director was reminded that California law requires facilities to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, facilities must submit the Unusual Incident/Injury form (LIC 624) to the Department. LPA's informed Director that all forms can be downloaded at www.ccld.ca.gov.

This facility provides Incidental Medical Services – IMS. LPA’s 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-care-centers/.

Director 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.
See 809 C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: LIVERMORE PLAYSCHOOL
FACILITY NUMBER: 010211015
VISIT DATE: 11/03/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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.

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

Exit interview conducted and report was reviewed with Director Robyn Zapien.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3