013416767-4-27-2023-52-CC-RHAR-CRARVJ-20230427132138

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013416767
Report Date: 04/27/2023
Date Signed: 04/27/2023 01:21:45 PM

Document Has Been Signed on 04/27/2023 01:21 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	HARVEST CHRISTIAN PRESCHOOL/DAYCARE		FACILITY NUMBER:	013416767
ADMINISTRATOR:	DISLA DE PEREZ, JUANA		FACILITY TYPE:	850
ADDRESS:	4360 HANSEN AVENUE		TELEPHONE:	(510) 713-8748
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY: 98	TOTAL ENROLLED CHILDREN: 27	CENSUS: 19	DATE:	04/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Juana Perez		TIME COMPLETED:	11:45 AM

NARRATIVE

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On April 27, 2023 at approximately 8:20am, Licensing Program Analyst (LPA) Haderer arrived unannounced for an annual inspection for compliance to Health and Safety. Present for the inspection was the site director Juana Perez 3 teachers; 19 children in care (all preschool age). The facility is in ratio today.

Sign in/out sheets are available and checked to verify children present were signed in. Classrooms have trash cans with tight fitting covers for the disposal of solid waste. Each classroom have functioning cold-water sinks with adequate soap and paper towels. The facility provides IMS for children, only one at this time needs an EpiPen. Proper forms were signed and medication was checked and found to be expired. See LIC 809D for deficiency.

The facility has 5 classrooms (2 are not in use at this time), a small kitchen/food prep area; 2 children’s bathrooms; a Chapel, and outside playground area surrounded by a 6-foot chain link fence. There are sturdy play structures, LPA observed that all play 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.

There is water available for the children and they also bring their own bottled water to school. Shade is available in the playground area teachers are always present when the children are outside. Children’s bathrooms are available and contain enough towels and soap supplies. The staff have a separate adult stall not used by the children. Fire and Earthquake disaster drills are conducted monthly, the last drill was conducted 4/13/2023.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

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: HARVEST CHRISTIAN PRESCHOOL/DAYCARE	FACILITY NUMBER: 013416767
	VISIT DATE: 04/27/2023

NARRATIVE

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The facility has fully charged 3A40BC fire extinguishers throughout the hallways and classrooms. The last annual inspection was done 9/27/2022. Trojan Systems Inc. conducts the fire systems inspections, the last inspection was completed on 4/20/2022 and all smoke detectors and the fire system are in good working order and passed inspection. Carbon monoxide detectors were present, tested and functioning. 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 out of the access of children.

There are no bodies of water accessible to children in care. The facility provides snacks for the children, menus were appropriately posted throughout the facility. All snack foods and refrigerated foods/beverages were checked and not expired.

Children’s files were reviewed. All files were complete and in good order. Staff files were reviewed. All files were complete and in good order.

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

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 Centers 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

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/27/2023 01:21 PM - It Cannot Be Edited

Created By: Russell Haderer On 04/27/2023 at 11:38 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: HARVEST CHRISTIAN PRESCHOOL/DAYCARE	FACILITY NUMBER: 013416767
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/27/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101223(a)(2)

Personal Rights

(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in that an EpiPen for a child in care was expired which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/01/2023
	Plan of Correction
1 2 3 4	Licensee to return expired medication and obtain an unexpired EpiPen from the child's parents and continue to keep it in a safe location in case it is needed.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Chandra Charles

LICENSING EVALUATOR NAME:

Russell Haderer

LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

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: HARVEST CHRISTIAN PRESCHOOL/DAYCARE	FACILITY NUMBER: 013416767
	VISIT DATE: 04/27/2023

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Site 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.

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 was one deficiency issued today for an expired EpiPen, see LIC809D for details. This report will remain on file for 3 years.

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

Exit interview conducted and report was reviewed with the Site Director Juana Perez.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

LIC809 (FAS) - (06/04)

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