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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010213410
Report Date: 05/05/2021
Date Signed: 05/25/2021 10:30:44 AM

Document Has Been Signed on 05/25/2021 10:30 AM - 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:HACIENDA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
010213410
ADMINISTRATOR:IMELDA ACOSTAFACILITY TYPE:
850
ADDRESS:4671 CHABOT DRIVETELEPHONE:
(925) 463-2885
CITY:PLEASANTONSTATE: CAZIP CODE:
94588
CAPACITY: 204TOTAL ENROLLED CHILDREN: 0CENSUS: 32DATE:
05/05/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Imelda AcostaTIME COMPLETED:
03:10 PM
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**THIS VISIT WAS CONDUCTED VIRTUALLY VIA THE PLATFORM ZOOM DUE TO THE COVID-19 PANDEMIC**
**THIS IS AN AMENDED REPORT TO THE ORIGINAL DRAFTED - LPA UPDATED LUNCH/SNACK INFORMATION**
A Case Management Visit was conducted on this date by Licensing Program Analyst (LPA), Melanie Otsuji. LPA met virtually with center director, Imelda Acosta. The center has submitted an application for a decrease in capacity from 204 to 136 children. 2 rooms (Room 7 & 8) and 2 play yards (Yard 7 & 8) are being removed from the preschool program. Hours of operation are from 7:30am-6:00pm, Monday through Friday. A virtual health and safety inspection was conducted inside and outside. The following is the total overall measurement:

INDOORS: 4937.36 square feet = 141 children
OUTDOORS: 14512.50 square feet = 193 children

Openers and closers have current CPR/FA. Playground equipment is in good condition. Drinking water is available inside and outside. This facility follows their IMS Plan of Operation. 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.

All toilets and hand-washing facilities are in safe and sanitary operating conditions. There is a kitchen inaccessible to children. Menus are posted. AM/PM snacks are provided and prepared on site with children bringing lunch from home. There is adequate variety and quantity of foods to meet the children's needs. The storage of napping equipment was observed. The sign in and out logs were reviewed. Facility has a functioning carbon monoxide detector.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2021
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: HACIENDA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 010213410
VISIT DATE: 05/05/2021
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A review of staff records on 05/05/2021 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. All licensing required documents are posted.

Zero Tolerance policies were explained. Notice of Site Visit form was provided and posted.
The center was found to be clean, safe, sanitary and in good repair. There were no deficiencies cited during this visit. A license for 136 preschool children will be issued effective today 5/5/2021. Preschool component will be operating out of Rooms 3 through Rooms 6.

An exit interview was conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2021
LIC809 (FAS) - (06/04)
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