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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700516
Report Date: 08/05/2021
Date Signed: 08/05/2021 01:24:27 PM

Document Has Been Signed on 08/05/2021 01:24 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:BUILDING KIDZ OF LIVERMOREFACILITY NUMBER:
015700516
ADMINISTRATOR:BRANNON, JANETFACILITY TYPE:
850
ADDRESS:3820 EAST AVENUETELEPHONE:
(408) 718-2970
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 78TOTAL ENROLLED CHILDREN: 0CENSUS: 31DATE:
08/05/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Deval MistryTIME COMPLETED:
01:30 PM
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On 08/5/2021 Licensing Program Analyst (LPA) Jaylena Miller conducted an UNANNOUNCED ANNUAL REQUIRED INSPECTION. LPA met with Facility Owner/Director Deval Mistry and the facility was toured to conduct a Health and Safety Inspection. Also present at the time of this inspection was 5 staff members and 31 preschool children. The facility is within ratio and capacity compliance today. This program operates out of the tulip and dahlia classrooms. At 11:15am All classrooms were inspected for age appropriate furnishings, equipment, and adequate storage for children’s belongings. LPA observed the cleanliness of floors and surfaces, the presence of working carbon monoxide detector, smoke detectors/fire alarms and a fully charged fire extinguisher size 3A40BC that is accessible throughout the facility. The bathrooms have age appropriate faucets in working condition, At 11:45am LPA observed one of the three toilets in the girl’s bathroom that is out of service, and per director the part has already been ordered to be fixed. At 12:00pm LPA toured the outdoor play area and observed it is fully fenced. There is enough padding under/around the climbing equipment. The play structures appear to be fully intact with no visual defects or concerns. There are no pools, hot tubs or other accessible bodies of water. Cleaning supplies/toxins are stored inaccessible to children. All required postings are present. The facility serves breakfast and snacks, menu is also posted. During COVID facility requires families to provided their own lunch. LPA reviewed storage of food, medication and medical equipment/supplies and is inaccessible to the children. Per director, there are no firearms present on the premises.

A copy of the facility personnel roster and children’s roster was obtained. At 10:30am LPA reviewed the file of 10 children enrolled in the program and 5 staff members files, who are fingerprint cleared, completion of Mandated Reporter training as well as proof of immunization's. The director opens and closes the facility and has a current CPR/First Aid certificates that expire 6/2022 respectfully, and proof of education and/or experience was also present. The center also conducts and documents fire and earthquake drills once every 6 months and the logs show that drills were conducted on 7/28/2021.

LPA also discussed with the Director that ALL assistants, volunteers, frequent visitors, over the age of 18, must be fingerprint cleared and associated prior to being in the presence of children in care. An immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

Please see LIC 809-C for continuance

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE: DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2021
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: BUILDING KIDZ OF LIVERMORE
FACILITY NUMBER: 015700516
VISIT DATE: 08/05/2021
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Director was reminded of the responsibility as a mandated reporter and the training's must be done once every two years and the CPR/First Aid training's must be EMSA approved. LPA also encouraged the Director to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded.

Individual Medical Services (IMS) policy was discussed. The Director is reminded that when any changes to the IMS plan is made, an updated Plan for Providing 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care centers and the ADA website at: http://www.ada.gov/childqanda.htm.


For licensing updates, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list

Effective August 1, 2003 California Law requires Child Care 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 for (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

There are no deficiencies cited today. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted with Director.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
LIC809 (FAS) - (06/04)
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