013421394-9-30-2022-52-CC-SKAR-CJRS56-20220930133349

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421394
Report Date: 09/30/2022
Date Signed: 09/30/2022 01:33:57 PM

Document Has Been Signed on 09/30/2022 01:33 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:	FREE TO BE ME CHILD CARE		FACILITY NUMBER:	013421394
ADMINISTRATOR:	BILLINGSLEY, JANETTE		FACILITY TYPE:	840
ADDRESS:	1040 FLORENCE RD.		TELEPHONE:	(925) 292-8377
CITY:	LIVERMORE	STATE: CA	ZIP CODE:	94550
CAPACITY: 65	TOTAL ENROLLED CHILDREN: 65	CENSUS: 0	DATE:	09/30/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Janette Billimgsley		TIME COMPLETED:	01:40 PM

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On September 30, 2022, Licensing Program Analyst (LPA) Simerjit Kaur conducted an UNANNOUNCED ANNUAL REQUIRED INSPECTION for School Age component and met with site director with Janet Billingsley. The facility was toured to conduct a Health and Safety Inspection. There were no staff and no children present during the inspection. The facility is within ratio and capacity compliance today. The facility operates Monday - Friday from 7:00am - 6:00pm.

This component operates out of classrooms Hive and Coop. There are adequate play and learning materials available. Furniture and equipment is age appropriate and in good repair. There is adequate heating, ventilation and lighting. There is individual storage space for each child. ll storage areas and cabinets for poisons are locked. There are working carbon monoxide detectors in each classroom, fire extinguisher and a pull down alarm device.

There are separate bathrooms for staff and the children. The bathrooms for children are located at the end of building and children should be supervised when going to bathrooms. Toilets and faucets working properly. Adequate lighting is provided in all bathrooms. All required postings are posted. The facility serves PM snacks. The menu is also posted for review. Drinking water is available inside and outside.

There are age appropriate play equipment, and materials for the school age children. The first aid kit (backpack) is available in the classroom. Sign-in and sign-out logs were reviewed to verify signatures. LPA reviewed staff file and children files. All opener and closer staff have CPR and First Aid certificates. All staff have current training and required documents in files. The facility has conducted fire/disaster drill on 9/11/22.

See LIC 809 C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022

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: FREE TO BE ME CHILD CARE	FACILITY NUMBER: 013421394
	VISIT DATE: 09/30/2022

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All required forms were posted in a public accessible area. There are no bodies of water accessible to children. Per director there are no firearms on the premises. A copy of the children’s roster and facility roster was obtained.

Assistant 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.

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 Center 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.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

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.

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

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022

LIC809 (FAS) - (06/04)

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