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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420525
Report Date: 10/25/2021
Date Signed: 10/25/2021 12:04:27 PM

Document Has Been Signed on 10/25/2021 12:04 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:CHILD DAY SCHOOL, LLC - PLEASANTONFACILITY NUMBER:
013420525
ADMINISTRATOR:CLOW, LINDSAYFACILITY TYPE:
840
ADDRESS:883 ROSE AVETELEPHONE:
(925) 462-1867
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 0DATE:
10/25/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Mia TiamzonTIME COMPLETED:
12:30 PM
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On October 25, 2021 at 8:15 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced 1 Year Required Inspection and met with Facility Representative, Mia Tiamzon. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Representative. There were no school age children present during this inspection and one (1) additional staff member. The facility consists of four (4) classrooms but one (1) room is used for school age children. This facility is a combination component with pre school age children licensee number (013420524). The facility was toured for a health and safety inspection. The hours of operation are 8:00 AM-5:00 PM, Monday -Friday

CLASSROOMS: The one classroom was inspected. There are adequate play and learning materials available. 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 facility representative's office, away from other children in care. The center has a smoke detector, a carbon monoxide detector, working telephone, pull down fire alarm system, and a fully charged 3A40BC fire extinguisher.

FOOD SERVICE AREAS: This facility provide snacks for the children. There are weekly menus posted at the facility. This facility has a kitchen with a refrigerator, this area is clean and free of evidence of rodents. Lunch is provided by Tuesday-Friday to children in care. All storage containers for solid waste have tight fitting covers that are in good repair.

BATHROOMS AND TOILETING AREAS: All sinks and faucets are in safe and sanitary operating condition. The staff's bathroom is separate from the children's bathroom. The children can reach the sinks and toilets. Supplies are available to the children.



See 809-C
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: CHILD DAY SCHOOL, LLC - PLEASANTON
FACILITY NUMBER: 013420525
VISIT DATE: 10/25/2021
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OUTDOOR PLAY AREAS: There's a play structure and a swing that is anchored with cushioning to absorb falls. There are trees that provides shade to children while at play and water cups/bottles to keep them hydrated.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Two (2) children's files and one (1) staff file were reviewed around 10:00 AM. All children files contain Identification & Emergency Information, Medical Consent, and Personal Rights forms, and all staff files have their required Health Screening and Employee Rights forms. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed, and certificates were reviewed. The Assistant Director's CPR and First Aid certificate is current and expires on 02/2022. The center is in compliance with the sign in and out procedure. Disaster drills are being conducted at least once every 6 months and the last one was conducted on 9/8/21. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: IMS is being provided at this facility. LPA inspected the medication, which is stored in a safe place that is inaccessible to children in care. Each of the medications has an unaltered label with the child’s name and date of issuance. The center is equipped with fully stocked first aid kits that are available in the classrooms.

California Law requires Child Care Centers licensees 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. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

See 809-C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
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: CHILD DAY SCHOOL, LLC - PLEASANTON
FACILITY NUMBER: 013420525
VISIT DATE: 10/25/2021
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LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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


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/process.

Facility representative 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.

There are no deficiencies cited today. 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, Mia Tiamzon

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
LIC809 (FAS) - (06/04)
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