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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010214002
Report Date: 08/30/2024
Date Signed: 08/30/2024 01:05:45 PM

Document Has Been Signed on 08/30/2024 01:05 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ADVENTURE TIME - PARKMONTFACILITY NUMBER:
010214002
ADMINISTRATOR/
DIRECTOR:		SANDERS, VALINAFACILITY TYPE:
840
ADDRESS:2601 PARKSIDE DRIVETELEPHONE:
(510) 713-2011
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 115TOTAL ENROLLED CHILDREN: 115CENSUS: 17DATE:
08/30/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Caaveri ThambirajahTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On August 30 2024, at 8:35am, Licensing Program Analyst (LPA) Randy Miranda arrived unannounced for an annual inspection for compliance to Health and Safety. Present for the inspection was Teacher Caaveri Thambiraja; Program Supervisor Jayjay Nagayo; Site Director Valina Sanders; three teacher’s aide; and 6 children in care (all school age). The center currently operates Monday – Friday 7:00 to 6:00PM, the center is in ratio today.

The child care center operates in a large portable room on the campus of Parkmont Elementary School. The children use the school yard and playground, but do not co-mingle with Parkmont School students. Adventure Time students are in a separate play area when Parkmont Students are present. All equipment is in safe condition and free from sharp, loose, or pointed parts and the areas around or under high climbing equipment has appropriate cushioned material that absorbs a fall. Access to drinking water is available and teachers are always present.



All documents required to be posted were appropriately posted on the walls: License; Emergency Disaster Plan; Earthquake Preparedness checklist; Notification of Parents Rights; Personal rights; Child seatbelt laws; menus; daily activity schedules.

The facility has 2 fully charged 3A40BC fire extinguishers, one mounted next to each door in the classroom. The last annual fire inspection conducted by The City of Fremont Fire Department, was completed on 8-22-2024. The carbon monoxide detector was tested and functioning. Heating and ventilation in the classroom is acceptable. Disaster drills are conducted at least once each month, the last drill was conducted 8/2024.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ADVENTURE TIME - PARKMONT
FACILITY NUMBER: 010214002
VISIT DATE: 08/30/2024
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The facility is clean and well organized with ample age-appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. Hazardous items/toxins are kept in a locked cabinet in the staff kitchen area out of the access of children. No bodies of water are accessible to children in care.

Items/toxins are kept in a locked cabinet in the staff kitchen area out of the access of children.

The facility does not provide lunch, snacks are provided. No snack items were found to be expired.



Children use the school bathrooms on campus, children are escorted in groups when they need to use the facilities. The staff has a separate adult bathroom located on campus.

The sign in/out sheets were reviewed and are accurate. Classrooms have trash cans with tight fitting cover for disposal of solid waste. There are 3 children that require incidental medication (EpiPen’s and antihistamines), and signed parent authorization forms were in the file.



Children's records were reviewed: LPA requested and reviewed facility roster. All files selected were complete and up to date. Staff files were reviewed and selected files were complete. Opening and closing staff have current CPR and first aid training.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ADVENTURE TIME - PARKMONT
FACILITY NUMBER: 010214002
VISIT DATE: 08/30/2024
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Administrator 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.

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/inspection-process.

There were no deficiencies cited during the inspection. This report will remain on file for 3 years.

A Notice of Site Visit was given and must remain posted for 30 days. Appeal Rights provided.

Exit interview conducted and report was reviewed with the Site Supervisor Valina Sanders and Program Supervisor Jayjay Nagayo.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024
LIC809 (FAS) - (06/04)
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