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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013412462
Report Date: 12/18/2024
Date Signed: 12/18/2024 05:34:50 PM

Document Has Been Signed on 12/18/2024 05:34 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 - GLENMOORFACILITY NUMBER:
013412462
ADMINISTRATOR/
DIRECTOR:
PITRUZZELLO, HEATHERFACILITY TYPE:
840
ADDRESS:4620 MATTOS DRIVETELEPHONE:
(510) 744-0772
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 115TOTAL ENROLLED CHILDREN: 115CENSUS: 69DATE:
12/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:19 PM
MET WITH:Mavi GoveaTIME VISIT/
INSPECTION COMPLETED:
05:45 PM
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On December 18, 2024 at approximately 2:19pm, Licensing Program Analyst (LPA) Randy Miranda arrived unannounced for an annual inspection for compliance to Health and Safety. Present for the inspection was the site director Mavi Govea, nine staff members, and 69 children in care. The center currently operates Monday-Friday 7:00AM to 6:00PM.

Adventure Time Glenmoor operates in a portable classroom on the campus of Glenmoor Elementary School. Children have use of the school yard and playground. The playground is majority free of sharp, loose or pointed parts. However, green planks that lines the curbs of the play area are loose and/or cracked, which may pose a risk to injury. LPA notified the site director and took photos of the affected area. Areas around or under high climbing equipment has tanbark material that absorbs a fall. Shade is available under building eaves on the property line and near the main school buildings. A water cooler is available to children 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. There are no waivers for this facility.

The facility has 2 fully charged fire extinguishers: 2A10BC mounted near the first door and a 3A40BC mounted near the second door. The last inspection was conducted 7/18/2024. Fremont Alarm conducted a fire system inspection on 8/29/2024; there were no violations, systems passed. The carbon monoxide detectors were tested and functioning. Disaster drills are conducted at least once every six months, Fire Drill conducted on 11/12/2024 and Earthquake Drill conducted on 10/07/2024. Heating and ventilation in the classroom is acceptable.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2024
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 - GLENMOOR
FACILITY NUMBER: 013412462
VISIT DATE: 12/18/2024
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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, however LPA observed a tear/rip on the carpet. Tear/rip does not pose a risk to injury. 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.

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 Glenmoor 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 two children that requires incidental medication (an inhaler and an epinephrine auto injector). 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 except for one, have current certificates for CPR and first aid training and Mandated Reporter certificates and are in compliance with Title 22 immunizations requirements. One staff member had an expired Mandated Reporter certificate.

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 access to water coolers to children. Lead testing is complete and documented.

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

DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024
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 - GLENMOOR
FACILITY NUMBER: 013412462
VISIT DATE: 12/18/2024
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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/.

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. Appeal Rights provided.

Exit interview conducted and report was reviewed with site director Mavi Govea.

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

DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024
LIC809 (FAS) - (06/04)
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