010213410-3-2-2022-52-CC-EWOS-CC5VQ4-20220302153743

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010213410
Report Date: 03/02/2022
Date Signed: 03/02/2022 03:37:52 PM

Document Has Been Signed on 03/02/2022 03:37 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:	HACIENDA CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	010213410
ADMINISTRATOR:	IMELDA ACOSTA		FACILITY TYPE:	850
ADDRESS:	4671 CHABOT DRIVE		TELEPHONE:	(925) 463-2885
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94588
CAPACITY: 136	TOTAL ENROLLED CHILDREN: 136	CENSUS: 41	DATE:	03/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:01 PM
MET WITH:	Imelda Acosta		TIME COMPLETED:	03:55 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 March 2, 2022 at 12:45 PM., Licensing Program Analyst (LPA) Elimika Woods and (LPA) Lorraine Dacanay-Breaux conducted an unannounced 1 Year Required Inspection and met with Director, Imelda Acosta. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Director. There were forty one (41) children present during this inspection and six (6) additional staff members. The facility consists of three (3) classrooms. This center has an infant component license number #010213411. The facility was toured for a health and safety inspection. The hours of operation are 7:30 AM-6:00 PM, Monday -Friday CLASSROOMS: The three (3) classrooms were inspected. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There are adequate play and learning materials available for each child, and individual storage space. The isolation area for sick children is in the conference room away from other children in care. The center has a combo smoke/ carbon monoxide detector, working telephone, pull down fire alarm system, and four (4) fully charged 2A10BC fire extinguishers. BATHROOMS AND TOILETING AREAS: The staff's bathroom is separate from the children's bathroom. All sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets. Supplies are available to the children. FOOD SERVICE AREAS: This facility provides morning and afternoon snacks for the children. There are weekly menus posted at the facility. LPA observed areas where they have refrigerators that are clean and free of evidence of rodents. There are no pesticides and other similar toxic substances stored in food storerooms. Lunch is not provided by the center. All storage containers for solid waste have tight fitting covers that are in good repair. See 809-C

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

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: 03/02/2022

NARRATIVE

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OUTDOOR PLAY AREAS: There's several play structures with slides that has cushioning to absorb children falls. There's also trees that provides shade to children while at play. There are several storage sheds that have locks to prevent children access on the preschoolers playground. The outside play areas also has water stations to keep the children hydrated.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Four (4) children's files and three (3) staff files were reviewed around 1:45 PM. All children files contain Personal Rights, Medical Consent forms, and Identification & Emergency forms. All staff files have required Health Screening forms, Employee Rights, and Criminal Records Statements. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed, and certificates were reviewed. Director's CPR and First Aid certificate is current and expires on 04/2023. The center is in compliance with the sign in and out procedure. Disaster drills are being conducted at least once every 6 months and the last one conducted was on 1/12/22. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: IMS is being provided at this facility. LPA inspected the medication, which is stored in a safe place that is inaccessible to children in care. Each of the medications has an unaltered label with the child’s name and date of issuance. The center is equipped with fully stocked first aid kits that are available in the classrooms.

California Law requires Child Care Centers licensees 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. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

See 809-C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

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: 03/02/2022

NARRATIVE

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LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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.

Facility representative 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.

There are no deficiencies. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Imelda Acosta.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

LIC809 (FAS) - (06/04)

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