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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010212832
Report Date: 11/23/2021
Date Signed: 11/23/2021 03:19:24 PM

Document Has Been Signed on 11/23/2021 03:19 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:KIDS CARE PLUS - STANTONFACILITY NUMBER:
010212832
ADMINISTRATOR:LUDKE, DENISEFACILITY TYPE:
840
ADDRESS:2644 SOMERSET AVE. + PORTABLE.TELEPHONE:
(510) 733-0775
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY: 85TOTAL ENROLLED CHILDREN: 0CENSUS: 11DATE:
11/23/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Annaleza RoqueTIME COMPLETED:
03:26 PM
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On 11/23/2021, Licensing Program Analyst (LPA) Jonathan Williams arrived at the facility unannounced for the purposes of conducting a Case Management inspection due to facility reopening after a period of inactivity. LPA was met by the Director, two fingerprint cleared and associated teachers, and 11 school-aged children in care. The facility operating hours are 7am-5:30pm M-F. The facility was toured to conduct a health and safety inspection.

At 1:10pm, LPA toured the facility classroom. The facility consists of one portable classroom on the site of Stanton Elementary School. The classroom is tidy and clean with heating and ventilation for safety and comfort. There are safe age-appropriate toys and learning materials available to children throughout the classroom. All hazardous materials and toxins including disinfectants and cleaning solutions were observed to be made inaccessible to children during today's inspection. Furniture accessible to children was observed to be age-appropriate, in operable condition, and free of loose, sharp, or pointed parts. Uncontaminated drinking water is available to children inside the facility. LPA observed adequate amounts of paper towels and hand soap available to children in the bathroom during today's inspection. No cleaning supplies were observed to be accessible to children during today's inspection.

At 1:15pm, LPA toured the outdoor play area. Areas around swings, slides, and high climbing equipment have cushioning material to absorb falls. There are no pools, hot tubs, ponds, or any other bodies of water accessible to children during today's inspection.

At 1:39pm, LPA toured the kitchen/food preparation area. The kitchen is free of litter, garbage, and evidence of rodents or other vermin during this inspection. Food is protected from contamination and, per staff, contaminated food is discarded immediately. Food/beverages capable of rapid spoiling are properly stored. Uncontaminated drinking water is available to children inside and outside the facility.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE: DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/23/2021
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDS CARE PLUS - STANTON
FACILITY NUMBER: 010212832
VISIT DATE: 11/23/2021
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The facility has a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detector (combined), and working telephone. The facility is in ratio today. Children's files and staff files were reviewed for proper documentation. All required forms are posted in public view, including daily activity schedule. Menus are posted. Children's roster was obtained. Director is hereby reminded that, as a condition of licensure, annual fees must be paid.

Incidental Medical Services (IMS) policy was discussed. This facility provides IMS to children in care at this time. 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.

Director was reminded that California Law requires licensed Child Care Centers 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. LPA informed the Director that all forms can be downloaded at www.ccld.ca.gov and encouraged the Director to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Director 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.

There are no deficiencies cited. A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided to the Director and the signature on this form acknowledges receipt of these rights.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021
LIC809 (FAS) - (06/04)
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