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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700613
Report Date: 10/08/2024
Date Signed: 10/08/2024 05:47:45 PM

Document Has Been Signed on 10/08/2024 05:47 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:LILY OF THE VALLEY EARLY EDUCATION & PRESCHOOLFACILITY NUMBER:
015700613
ADMINISTRATOR/
DIRECTOR:
KHAN, ABADATFACILITY TYPE:
850
ADDRESS:348 NORTH CANYONS PARKWAYTELEPHONE:
(408) 431-9226
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY: 142TOTAL ENROLLED CHILDREN: 23CENSUS: 17DATE:
10/08/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Abadat KhanTIME VISIT/
INSPECTION COMPLETED:
05:46 PM
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On 10/8/2024 at 9:20am Licensing Program Analyst (LPA) Morgan Pringle met with Director Abadat “Abi” Khan for an Unannounced Annual/Random inspection. There were seventeen (17) preschool age children, and two (2) additional staff members present during the inspection. LPA toured six (6) classrooms, Early Preschool (C101 and C106), Preschool (Room C109 and C111), PreK (C113) and TK (C115) for a health and safety inspection. Preschool rooms C101, C106, C111 and C115 are currently not in use. The facility is located on the right side of the Cornerstone Church grounds. The facility operates from 7:00am – 6:00pm, Monday – Friday. The facility holds a license for an infant component as well (#015700612).

The classrooms were observed to have ample age-appropriate materials for the children’s learning and play that were observed to be clean, properly stored and in proper working order. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. All sinks and toilets are located inside the classrooms and were observed to be clean and in proper working order. All children have access to clean drinking water in each classroom. There are multiple smoke detectors, carbon monoxide detectors, fire extinguishers, and first aid kits on site. The facility does not transport children.

The on-site food prep room is clean, well maintained, and free from defects. All food on site is properly labeled and stored. Facility provides lunch and morning/afternoon snacks. All hazards and chemicals are kept separate from the food as well. All food that will be brought from the children’s home will be properly labeled and stored.


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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2024
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LILY OF THE VALLEY EARLY EDUCATION & PRESCHOOL
FACILITY NUMBER: 015700613
VISIT DATE: 10/08/2024
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The outside areas are clean, with ample age-appropriate materials for the children. The play structures are anchored into the ground. The slide is sturdy and cushioned underneath. There is also plenty of shade for the children with surrounding trees and buildings overhangs. LPA did not observe any harmful or unattended bodies of water in or around the facility.

The facility is operating within its licensed capacity is in ratio. All staff working at the facility have obtained a criminal record clearance, exemption, or have transferred their clearances or exemption. The fire/disaster drill log is incomplete with the last drill logged 9/26/2024. A physical census of the children was taken and cross referenced with the electronic sign-in and out log. All children have been signed in by their authorized representative. All required postings, including the menu, are posted in the entry way of the facility. LPA obtained a sample of the children’s files, staff files, and the facility files. All files were complete.

No deficiencies cited during LPAs inspection.

Licensee was reminded that California law requires facilities to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, facilities must submit the Unusual Incident/Injury form (LIC 624) to the Department. Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Personnel and facility roster must be properly maintained, and fire/disaster drills must be conducted at least every six (6) months and documented. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov.

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. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LILY OF THE VALLEY EARLY EDUCATION & PRESCHOOL
FACILITY NUMBER: 015700613
VISIT DATE: 10/08/2024
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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/.

Director 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.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with facility Director Abadat “Abi” Khan.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024
LIC809 (FAS) - (06/04)
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