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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070213231
Report Date: 09/07/2023
Date Signed: 09/07/2023 03:48:54 PM

Document Has Been Signed on 09/07/2023 03:48 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:MURWOOD KEYSPOTFACILITY NUMBER:
070213231
ADMINISTRATOR:MELISSA SHERIDAN MULLERFACILITY TYPE:
840
ADDRESS:2050 VANDERSLICE AVENUETELEPHONE:
(925) 932-8118
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94596
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 85DATE:
09/07/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Melissa SheridanTIME COMPLETED:
04:15 PM
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On 9/7/23 Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Case Management inspection at Murwood Keyspot and met with Director, Melissa Sheridan Purpose of inspection is to follow up and conclude investigation of an incident that was reported by the facility to Licensing Department on 8/21/23.

LPA conducted initial investigations on 8/23/23 and 8/24/23, interviewed staff and children, did facility observations and walk through.

It was determined that on 8/18/23 during play activity time, a child C1 was playing dodgeball with other children in the Multipurpose Room. There were at least 3 staff present with approximately 20-30 children. C1 was running, lost balance, fell face down on the piano, and injured ridge of the nose, sustained swelling and bruising on the nose. Staff did not visually see the incident happening as they were supervising and attending to other children at that time. Staff applied first aid in a timely manner and called child's parents immediately. C1 did not require medical attention afterwards and returned to facility in few days.

No deficiency was cited for the incident today. A Technical Violation/Advisory Note was issued reminding facility that staff must provide active 100% visual supervision of all children at all times.

Exit interview was conducted with Director, Melissa Sheridan. A NOTICE OF SITE VISIT WAS ISSUED, MUST BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2023
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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