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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419494
Report Date: 02/12/2025
Date Signed: 02/12/2025 01:15:48 PM

Document Has Been Signed on 02/12/2025 01:15 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:PALM ACADEMYFACILITY NUMBER:
013419494
ADMINISTRATOR/
DIRECTOR:		YAO, LIPINGFACILITY TYPE:
840
ADDRESS:2856 WASHINGTON BLVDTELEPHONE:
(510) 979-9794
CITY:FREMONTSTATE: CAZIP CODE:
94539
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 0DATE:
02/12/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Liping YaoTIME VISIT/
INSPECTION COMPLETED:
01:25 PM
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On 2/12/2025 Licensing Program Analyst (LPA) Melanie Otsuji met with Director, Liping Yao for an Unannounced Annual/Required Inspection. At the time of LPA's visit, there were no school age children present. A health and safety inspection was conducted both inside and outside. The facility operates 8AM – 6PM, Monday – Friday. The facility is dual licensed and holds a preschool (Facility #013419452) and infant (Facility #013420570) license.

Facility staff transport children from school to the facility. Vehicles utilized for transportation have current insurance and facility staff have a valid drivers license. There are adequate play and learning materials available. LPA observed all 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 in the front office. The facility has smoke detectors, working telephone, and fully charged fire extinguishers and carbon monoxides detectors.

The staff's bathroom is separate from the children's bathroom. All sinks and faucets are in safe and sanitary operating condition. This facility provide afternoon snacks for the children and all meals and snacks during full days. There are weekly menus posted at the facility. All storage containers for solid waste have tight fitting covers that are in good repair.

The outside play yard is clean with age-appropriate materials for the children. There is plenty of shade from building overhang and umbrellas. LPA did not observe any harmful or unattended bodies of water in or around the facility.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2025
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: PALM ACADEMY
FACILITY NUMBER: 013419494
VISIT DATE: 02/12/2025
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LPA reviewed a random sample of children's files and staff files. LPA verified both opening and closing staff have current CPR/First aid training. Disaster drills are being conducted and documented at least once every 6 months. All required documents are posted in a public accessible area.

Licensee 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 child care 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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in https://www.cdss.ca.gov/Portals/9/CCLD/PINs/2021/CCP/PIN-21-21_1-CCP.pdf. LPA referred facility representative to the Department website for lead: https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) 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/.
Licensee 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.

No deficiencies noted on today's date. A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Director, Liping Yao.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025
LIC809 (FAS) - (06/04)
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