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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013411129
Report Date: 08/31/2023
Date Signed: 08/31/2023 11:56:11 AM

Document Has Been Signed on 08/31/2023 11:56 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ADVENTURE TIME - NILESFACILITY NUMBER:
013411129
ADMINISTRATOR:KRISTIE ARRENDONDOFACILITY TYPE:
840
ADDRESS:37141 2ND STREETTELEPHONE:
(510) 797-4806
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 110TOTAL ENROLLED CHILDREN: 114CENSUS: 19DATE:
08/31/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:24 AM
MET WITH:Kristie ArredondoTIME COMPLETED:
12:10 PM
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On August 31, 2023 at approximately 8:30am, LPA Haderer arrived unannounced for an annual inspection for compliance to Health and Safety. Present for the inspection was the site director Kristie Arredondo, two staff members and no children in care. During the inspection, two additional teachers and 19 children arrived (Kindergarten age 5-6). The center currently operates from 7:00AM to 6:00PM.

Adventure Time Niles operates in a portable classroom on the campus of Niles Elementary School. Children have use of the school yard and playground. The playground is free of sharp, loose or pointed parts, areas around or under high climbing equipment has tanbark material that absorbs a fall. Shade is available under building eaves and large trees on the property line and near the main school buildings. Fresh bottled drinking water is available to children, 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. There are no waivers for this facility.

The facility has 2 fully charged 3A40BC fire extinguishers, one mounted next to each classroom door. The last annual inspection was done 8-03-2023. Adatto Security & Communications – dba. Fremont Alarm conducted a fire system inspection on 11/02/2022; there were no violations, systems passed. The carbon monoxide detectors were tested and functioning. Disaster drills are conducted at least once every six months, the last drill was conducted August 30, 2023. Heating and ventilation in the classroom is acceptable.
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. There are no bodies of water accessible to children in care. Classrooms have trash cans with tight fitting cover for the disposal of solid waste.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2023
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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ADVENTURE TIME - NILES
FACILITY NUMBER: 013411129
VISIT DATE: 08/31/2023
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The center provides snacks and children bring their own lunch from home. Dry goods and canned foods were checked, everything was within expire date, there was fat free milk in the refrigerator. Children use Nile School bathrooms. The staff have separate adult bathrooms located in the school.

Children's records were reviewed: All files selected were complete and up to date. At this time, the facility has a child that requires incidental medication (an inhaler and anti-histamines for allergies). Required paperwork was available, medications were checked and not expired.

Staff files were reviewed. All staff subjected to criminal review have been cleared and associated to the facility. All staff have current certificates for CPR and first aid training and Mandated Reporter certificates and are in compliance with Title 22 immunizations requirements.

Site 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). This facility operates out of a portable classroom that does not have any water lines to the building. Children bring their own water bottles and the school also provides bottled water to children. No lead testing is required.

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 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/.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ADVENTURE TIME - NILES
FACILITY NUMBER: 013411129
VISIT DATE: 08/31/2023
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Site Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

There were no deficiencies issued today. This report will remain on file for three years.

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

Exit interview conducted and report was reviewed with site director Kristie Arrendando.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
LIC809 (FAS) - (06/04)
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