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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422039
Report Date: 07/02/2024
Date Signed: 07/02/2024 03:14:43 PM

Document Has Been Signed on 07/02/2024 03:14 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 AT AMADORFACILITY NUMBER:
013422039
ADMINISTRATOR/
DIRECTOR:		SALGADO, KATRINAFACILITY TYPE:
840
ADDRESS:2100 E. CANTARA DRIVETELEPHONE:
(925) 560-8191
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 215TOTAL ENROLLED CHILDREN: 215CENSUS: 50DATE:
07/02/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:35 PM
MET WITH:director,Katrina Salgado TIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Jyoti Saini met with facility representative Katrina Salgado for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the director. Present during the inspection director and eight (8) staff members supervising 50 children. The program consists of two sessions: 7:00 am to 8:15 am and 12:00 pm to 6:00 pm Monday - Friday in room EDCC #101 (AKA owls ages TK-1st grade) and room EDCC #100 (AKA falcon ages 2nd grade to 5th grade) on the AMADOR ELEMENTARY SCHOOL CAMPUS—the facility currently operating summer program: Monday – Friday, 7:00 am to 6:00 pm. The facility was inspected indoor and outdoor today for health and safety hazards and the following was observed;
There are no bodies of water, firearms, or weapons on the premises. The Center is in good condition with proper temperature and ventilation, and is free of any hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. The boys and girls have separate bathrooms. The boys bathroom have two toilets and two sinks and girls bathroom have three toilets and two sinks. The staff have a separate bathroom. The bathrooms appear to be safe, sanitary, and free of any hazardous items. Drinking water is readily available through water fountains and water bottles brought from home. There is a menu posted for the entire month. The facility serves snacks and requires children to bring their own lunch. LPA reviewed storage of food and observed that food is in original packaging and labeled with expiration date.
The classroom has appropriate postings. The last Emergency Drill was conducted on 06/27/2024 and is properly logged. Medications are stored on a high shelf in each classroom, which is inaccessible to children in care. The facility requires parents to sign the children in and out electronically using the KT( Kangroo Time) app. The facility roster was reviewed and a copy was obtained.
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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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 AT AMADOR
FACILITY NUMBER: 013422039
VISIT DATE: 07/02/2024
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There is a working fire alarm system at the elementary. The room has a working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available. All children have a record of emergency identification information. Children and Staff records were reviewed . All staff has taken Mandated Reporter training. . The opening and closing teacher has a current Pediatric First Aid/CPR certificate on file.

Criminal Record Clearance -

Facility representative 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.

Lead Testing – CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:

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.
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
Incidental Medical Services (IMS)
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 PIN 22-02-CCP. 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/.
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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
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 AT AMADOR
FACILITY NUMBER: 013422039
VISIT DATE: 07/02/2024
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MyChildCarePlan.org
Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

No deficiency was 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, Katrina Salgado
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
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