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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420903
Report Date: 08/07/2024
Date Signed: 08/07/2024 12:08:56 PM

Document Has Been Signed on 08/07/2024 12:08 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:EXTENDED DAY CHILD CARE - EDCC - KOLB ELEMENTARYFACILITY NUMBER:
013420903
ADMINISTRATOR/
DIRECTOR:		TAMARA BRELLANDFACILITY TYPE:
840
ADDRESS:3150 PALERMO WAYTELEPHONE:
(925) 828-2666
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 75DATE:
08/07/2024
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:16 AM
MET WITH:Director, Tamara Brelland TIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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A Case Management Visit was conducted today by Licensing Program Analyst (LPA) Jyoti Saini. LPA Saini met with the director, Tamara Brelland. An application was submitted to add room G3 and remove room L2 with no change to capacity. The school-age program is located on the Kolb Elementary School campus. The program currently utilizes Rooms L2, EDCC Buidling and MULTI-PURPOSE ROOM (MPR) on school grounds. The hours of operation are from 7:00 AM to 6:00 PM, Monday through Friday. Present today were director and five staff members supervising 75 children. A health and safety inspection was conducted inside and outside. The center has an approved fire clearance from Dublin Fire Prevention Services.

LPA did not observe any hazardous items, defects, or dangerous conditions. Classroom G3 has a fully charged fire extinguisher and carbon monoxide/smoke detection system.

INDOORS: EXEMPT
OUTDOORS: EXEMPT
The facility utilizes Kolb Elementary playground structures, blacktop, and grassy areas. Drinking water is available inside and outside through water fountains and bottles brought from home. The facility provides AM/PM snacks. Menus are posted.The school district provides lunch to the children however, during summer children are require to bring their own lunch. The facility uses the KT Connect app to sign in and sign out the children. Sign in/out logs were checked and matches current census. Opening and Closing staff have current Pediatric CPR/First Aid.

see next page..
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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: EXTENDED DAY CHILD CARE - EDCC - KOLB ELEMENTARY
FACILITY NUMBER: 013420903
VISIT DATE: 08/07/2024
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A license approving 120 school-aged children and use of Room G3 and previously licensed space Multi-purpose Room, EDCC Room, and school playground is effective today, 08/07/2024.

An exit interview was conducted and report was reviewed with facility representative, Tamara Brelland.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
LIC809 (FAS) - (06/04)
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