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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073400194
Report Date: 05/10/2023
Date Signed: 05/10/2023 02:19:45 PM

Document Has Been Signed on 05/10/2023 02:19 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:KIDS AT WORKFACILITY NUMBER:
073400194
ADMINISTRATOR:LORI SULLIVANFACILITY TYPE:
850
ADDRESS:255 GLACIER DRIVETELEPHONE:
(925) 313-2380
CITY:MARTINEZSTATE: CAZIP CODE:
94553
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 17DATE:
05/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:MICHELLE NAILTIME COMPLETED:
02:45 PM
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LICENSING PROGRAM ANALYST TASHA ALEXANDER MET TODAY WITH CENTER DIRECTOR MICHELLE NAIL FOR AN UNANNOUNCED 1 YEAR/REQUIRED INSPECTION. UPON ARRIVAL THERE ARE 7 PRESCHOOL AGE CHILDREN PRESENT ALONG WITH 3 STAFF MEMBERS. THE DIRECTOR AND ASSISTANT DIRECTOR ARE NOT INCLUDED IN THE RATIOS TODAY. THE CLASS ROOMS ARE LOCATED INSIDE OF ONE ROOM AND SEPARATED BY PLEXIGLASS PARTITIONS. TODAY THE ROOMS WERE INSPECTED AND HAVE AGE APPROPRIATE FURNITURE WHICH APPEARS TO BE IN GOOD REPAIR. THE INDOOR AND OUTDOOR ACTIVITY SPACE APPEARED TO BE IN GOOD REPAIR AND AGE APPROPRIATE. DISINFECTANTS, CLEANING SOLUTIONS, POISONS AND OTHER ITEMS THAT ARE DANGEROUS TO CHILDREN WERE INACCESSIBLE DURING TODAY'S INSPECTION AND LOCATED INSIDE OF THE STAFF BATHROOM. THE SINKS WERE OBSERVED TO BE IN OPERABLE CONDITION. THE FLOORS ARE FREE OF TRIPPING HAZARDS. BREAKFAST, LUNCH AND SNACKS ARE PROVIDED BY THE FACILITY. A WEEKLY MENU IS POSTED AND IS VISIBLE FOR PARENTS TO REVIEW . THE KITCHEN AREA WAS OBSERVED TO BE CLEAN AND FREE OF EVIDENCE OF RODENTS. FOOD/SNACKS ARE PROTECTED AGAINST CONTAMINATION. ALL STORAGE CONTAINERS FOR SOLID WASTE HAVE TIGHT FITTING LIDS THAT ARE IN GOOD REPAIR. DRINKING WATER IS AVAILABLE INDOORS AND CHILDREN BRING THEIR OWN WATER BOTTLES OUTDOORS. OUTDOOR ACTIVITY SPACE IS FOUND AND PLAYGROUND EQUIPMENT WAS OBSERVED TO BE SAFE AND FREE OF HAZARDS WITH APPROPRIATE MATERIAL TO ABSORB FALLS. THERE ARE CANOPIES ON THE PLAYGROUND TO PROVIDE SHADED AREAS FOR CHILDREN.

THE LICENSEE UNDERSTANDS THAT PRIOR TO WORKING OR VOLUNTEERING IN A LICENSED CHILD CARE FACILITY, ALL INDIVIDUALS SUBJECT TO CRIMINAL RECORD REVIEW SHALL OBTAIN A CLEARANCE OR CRIMINAL RECORD EXEMPTION.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDS AT WORK
FACILITY NUMBER: 073400194
VISIT DATE: 05/10/2023
NARRATIVE
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A SAMPLE OF CHILDREN'S RECORDS WERE REVIEWED. FILES REVIEWED CONTAINED EMERGENCY INFORMATION AND MEDICAL CONSENT FORMS. STAFF RECORDS WERE ALSO REVIEWED. TEACHERS PRESENT TODAY MEET QUALIFICATION REQUIREMENTS AND HAVE HEALTH SCREENING FORMS IN FILE. AT LEAST ONE PERSON PRESENT HAS CURRENT CPR & 1ST AID. MANDATED REPORTER CERTIFICATES ARE UP TO DATE.

Licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a 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, available at: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
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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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDS AT WORK
FACILITY NUMBER: 073400194
VISIT DATE: 05/10/2023
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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

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.

PLEASE SEE 809-D FOR CITATION

An exit interview was conducted. A notice of site visit was posted.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
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Document Has Been Signed on 05/10/2023 02:19 PM - It Cannot Be Edited


Created By: Tasha Hackett-Alexander On 05/10/2023 at 01:09 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDS AT WORK
FACILITY NUMBER: 073400194

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care. THIS REQUIREMENT IS NOT MET AS EVIDENCED BY A REVIEW OF RECORDS WHICH REVEALED MS AMIE IS MISSING PROOF OF PERTUSSIS VACCINE, MS. SHELBY IS MISSING PROOF OF MEASLES VACCINE, MS. MICHELLE IS MISSING PROOF OF MEASLES VACCINE AND MS. ANGELINA IS MISSING PROOF OF MEASLES, PERTUSSIS AND FLU VACCINES.
POC Due Date: 05/24/2023
Plan of Correction
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LICENSEE WILL HAVE EACH STAFF MEMBER OBTAIN THEIR IMMUNIZATION RECORDS AND SUBMIT COPIES TO COMMUNITY CARE LICENSING BY 5/24/23
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Loretta Dyson
LICENSING EVALUATOR NAME:Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:
DATE: 05/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/10/2023


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