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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013415297
Report Date: 12/23/2022
Date Signed: 12/23/2022 10:18:33 AM

Document Has Been Signed on 12/23/2022 10:18 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:LARPD - ALTAMONT CREEK KID'S ZONEFACILITY NUMBER:
013415297
ADMINISTRATOR:JENNIFER SIRANNIFACILITY TYPE:
840
ADDRESS:6500 GARAVENTA RANCH ROADTELEPHONE:
(925) 960-2460
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 140TOTAL ENROLLED CHILDREN: 140CENSUS: 0DATE:
12/23/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Nancy BlairTIME COMPLETED:
10:30 AM
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On December 23, 2022, Licensing Program Analyst (LPA) Simerjit Kaur conducted an announced Case Management Inspection. LPA Kaur met with Director Jennifer Siranni and Youth Services Administrative Nancy Blair. This facility was on inactive status effective 6/29/2022 and would like to be placed back on active status. LPA Kaur toured the facility with Jennifer Siranni and Nancy Blair. The facility is located on campus of Altamont Creek Elementary School. The campus also has Heritage Charter program: Right At School. The Director is aware the school program may not comingle with the Heritage school and elementary school. The facility operates from Monday through Friday 7:00 AM - 8:30 AM, and 1:30 PM - 6:00 PM. During school district breaks, the facility operates Monday through Friday 7:00 AM - 6:00 PM.

LPA discussed the importance of keeping hazardous items out of the reach of children. Facility is currently licensed for Rooms A and B. Room B has staff bathroom, children bathroom, and office. The isolation area is the office. Facility director has current CPR and First Aid certificate which was completed on 3/26/2021 and Mandated Reporter Training completed on 3/17/2022. The facility has multiple carbon monoxide detectors, charged 2A10BC fire extinguishers and smoke detector/alarm system monitored by the Altamont Creek Elementary School. LPA Kaur spoke with Nancy Blair in regards to hiring qualified staff to care for the children. Facility will utilize black top and fenced play structure on the left side for outdoor activity space except the metal dome. The facility will also utilize the grass area and will provide 100% supervision during outdoor play time.
Director was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.
Continue on 809C.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 12/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/23/2022
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: LARPD - ALTAMONT CREEK KID'S ZONE
FACILITY NUMBER: 013415297
VISIT DATE: 12/23/2022
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Director 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.

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 Center 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.

Reminder: California Law requires Child Care Centers 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.

Facility is placed on active status effective today 12/23/2022.


This report shall remain on file for 3 years. A Notice of Site Visit was provided to the Licensee. Exit interview was conducted.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2022
LIC809 (FAS) - (06/04)
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