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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419480
Report Date: 03/17/2023
Date Signed: 03/17/2023 03:34:49 PM

Document Has Been Signed on 03/17/2023 03:34 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:HEARTS AND HANDS CHRISTIAN CHILDCARE & PRESCHOOLFACILITY NUMBER:
013419480
ADMINISTRATOR:OJEDA, VANESSAFACILITY TYPE:
850
ADDRESS:4111 ALDER AVENUETELEPHONE:
(510) 792-6200
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 100TOTAL ENROLLED CHILDREN: 58CENSUS: 39DATE:
03/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Miss Lori and Miss HazelTIME COMPLETED:
03:45 PM
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On March 17, 2023 at approximately 11:00 am, LPA Haderer arrived unannounced for an annual inspection for compliance to Health and Safety. The new CARE tool was used for the inspection. The site director was out sick and in her place, LPA met with designees Miss Lori Serpa and Miss Hazel Meregillino There were 7 teachers present for the inspection and 39 children in care (all preschool age). The facility is in ratio today.

The facility has 4 classrooms and 3 other sectioned off areas in the main gymnasium room with various ocean themed names: Sea Turtles; Sharks; Star Fish; Dolphins; Seahorse; Science room and an un-named area with not children at this time.



The children have two playground areas with artificial grass and a large play structure. The playground area is divided into two sections with an approved waiver requiring the children to alternate their time so as not to overcrowd the area and violate the 75 square foot per child requirement. The waiver is prominently posted in the lobby. 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 a water jug 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.

Sign in/out sheets are done manually. One child was not signed in by their parent. Classrooms have trash cans with tight fitting cover for the disposal of solid waste. The facility does not provide any incidental medical services such as inhalers or EpiPen’s to children in care. Parents are aware that in an emergency 911 will be called.
Children’s bathrooms are available in the classrooms, there are enough towels and soap supplies. The staff have separate adult bathroom located on campus. Fire and Earthquake disaster drills are conducted monthly, the last drill was conducted 3-1-2023.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HEARTS AND HANDS CHRISTIAN CHILDCARE & PRESCHOOL
FACILITY NUMBER: 013419480
VISIT DATE: 03/17/2023
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The facility has fully charged 3A40BC fire extinguishers in the hallways, kitchen and classrooms, the last annual inspection was done 2/9/2021. Trojan Systems Inc. conducts fire inspections. The last inspection was completed in 3/1/2022 and all smoke detectors and the fire system are in good working order and passed inspection. Carbon monoxide detector was 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 dry good and canned foods were checked and not expired.

Staff files were reviewed. Two new staff members completed the Mandated Reporter General training, but not the required Child Care Provider section (AB1207). New staff members have 90 days to complete this. One new staff member did not complete the required Health Screening Report with a physician See LIC809D for deficiency. At least one opening and one closing staff member had unexpired CPR/1st Aid certificates. All staff subjected to criminal review have been cleared and associated to the facility.
Children's records were reviewed: LPA requested and reviewed facility roster, All required documents were available.

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.

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

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HEARTS AND HANDS CHRISTIAN CHILDCARE & PRESCHOOL
FACILITY NUMBER: 013419480
VISIT DATE: 03/17/2023
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Miss Lori Serpa 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 1 deficiency issued today, see LIC809D.

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 Miss Lori Serpa, Master Teacher.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/17/2023 03:34 PM - It Cannot Be Edited


Created By: Russell Haderer On 03/17/2023 at 02:56 PM
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: HEARTS AND HANDS CHRISTIAN CHILDCARE & PRESCHOOL
FACILITY NUMBER: 013419480

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
(g) All personnel, including the licensee, administrator and volunteers, shall be in good health and shall be physically and mentally capable of performing assigned tasks.
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that one new staff member has not completed the Health Screening report not more than one year prior or seven days after employment which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/24/2023
Plan of Correction
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Employee to complete health screening by a physician and provide signed copy of report to employer. Licensee to forward proof of compliance to LPA.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: 03/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2023


LIC809 (FAS) - (06/04)
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