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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013411335
Report Date: 11/15/2021
Date Signed: 11/15/2021 11:35:18 AM

Document Has Been Signed on 11/15/2021 11:35 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:SUPPORTING FUTURE GROWTH #7FACILITY NUMBER:
013411335
ADMINISTRATOR:DARBY, ANGELAFACILITY TYPE:
850
ADDRESS:22584 SOUTH GARDEN AVENUETELEPHONE:
(510) 780-9120
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 7DATE:
11/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Tran QuachTIME COMPLETED:
12:15 PM
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On November 15, 2021 at 8:15 AM., Licensing Program Analyst (LPA) Elimika Woods and LPA Kelly Phan conducted an unannounced 1 Year Required Inspection and met with the Facility Representative, Tran Quach. LPA disclosed the purpose of the inspection and was granted entry into the facility by the representative. There were (7 children present during this inspection and one additional staff member. The facility consists of four (4) classrooms. The facility was toured for a health and safety inspection. The hours of operation are 8:00 AM-5:00 PM, Monday -Friday

CLASSROOMS: The four (4) classrooms were inspected. There are adequate play and learning materials available. 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 is proper individual storage space for each child. The isolation area for sick children is the library area, away from other children in care. The center has smoke detectors, working telephone, and two (2) 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 provide snacks for the children. There are weekly menus posted at the facility and lunch is provided by the center to children in care. 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: 11/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2021
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: SUPPORTING FUTURE GROWTH #7
FACILITY NUMBER: 013411335
VISIT DATE: 11/15/2021
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OUTDOOR PLAY AREAS: There's a play structure with a slide that has cushioning to absorb falls and a swing set that is anchored for stability. There's also a canopy that provides shade to children while at play.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Three (3) children's files and two (2) staff files were reviewed around 9:30 AM. All staff files have required health screening and Employee Rights and all children files contain Identification & Emergency, Personal Rights, and Medical Consent forms. LPA reviewed the facility roster and obtained a copy. Mandated Reporter Training was discussed, and certificates were reviewed. The Facility Representative CPR and First Aid certificate was not in her file but she will forwarded the certificate to LPA within two weeks. 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 8/12/21. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: There's no IMS being provided at this time and no medication being stored at the facility. The center is equipped with a fully stocked first aid kit that is available in the classroom.

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.

See 809-C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2021
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: SUPPORTING FUTURE GROWTH #7
FACILITY NUMBER: 013411335
VISIT DATE: 11/15/2021
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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.

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



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 cited today. 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, Tran Quach.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2021
LIC809 (FAS) - (06/04)
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