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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405614
Report Date: 10/04/2022
Date Signed: 10/04/2022 05:41:08 PM

Document Has Been Signed on 10/04/2022 05:41 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:LITTLE BRIDGES CHILD CARE CENTERFACILITY NUMBER:
073405614
ADMINISTRATOR:KIRK, JACQUEFACILITY TYPE:
830
ADDRESS:9015 SOUTH GALE RIDGE ROADTELEPHONE:
(925) 498-9808
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY: 24TOTAL ENROLLED CHILDREN: 23CENSUS: 20DATE:
10/04/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Jacque KirkTIME COMPLETED:
05:41 PM
NARRATIVE
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On 10/4/2022 at 10:20am Licensing Program Analyst (LPA) Morgan Pringle met with Director Jacque Kirk, for an Unannounced Annual Inspection. During the inspection there were twenty (20) infants and seven (7) teachers. Two (2) classrooms, The Loving Lambs and The Faithful Frogs, were toured for a health and safety inspection. The facility operates from 7:30am – 6:00pm, Monday – Friday. The facility is dual licensed and holds a preschool and school age license as well.

The facility has ample age appropriate materials in the classrooms that were observed to be clean and in good condition. All toxins, medications, cleaning products, and hazardous materials were observed to be in inaccessible areas. All cribs are properly maintained and free from defects. All bottles and food are properly stored and labeled. The diapering area is clean, properly cushioned and free from any defects. There are carbon monoxide and smoke detectors on site and fully charged fire extinguishers on site as well. The outside play yard is fully fenced, clean, and free from hazards with shade for the children. LPA did not observe any harmful or unattended bodies of water in or around the facility.



The facility is operating within its licensed capacity and is in ratio. All proper postings are made visible in the office of the facility. All food provided by the facility is properly stored and labeled in the staff lounge. All food preparation areas are clean and free from all hazards. The fire/disaster drill log was is complete with the last drill logged on 5/17/2022. LPA obtained the sign in/out sheets for both classrooms. During LPA’s record review it was found that four (4) children in the Faithful Frogs classroom were not properly signed into the facility by their parent/authorized representative (See LIC809D). LPA also observed that all fifteen (15) infants in the Faithful Frogs classroom did not have an Infant Needs and Services Plan (See LIC809D). All staff have obtained a criminal record clearance. LPA obtained the facility files, children’s files and staff files. Two staff members were missing infant/toddler units and one child was missing LIC627: Consent for Medical Treatment (See LIC9102-TV). Continued on LIC809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2022
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: LITTLE BRIDGES CHILD CARE CENTER
FACILITY NUMBER: 073405614
VISIT DATE: 10/04/2022
NARRATIVE
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Deficiencies Cited
Four (4) children not signed in
All children in Faithful Frogs classroom missing Needs and Services Plan

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities 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 form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.

Continued on LIC809-C

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

DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022
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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: LITTLE BRIDGES CHILD CARE CENTER
FACILITY NUMBER: 073405614
VISIT DATE: 10/04/2022
NARRATIVE
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Director was reminded that all adults 18 and over, 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 Child Care Center. 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.

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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Jacque Kirk.

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

DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/04/2022 05:41 PM - It Cannot Be Edited


Created By: Morgan Pringle On 10/04/2022 at 04:37 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: LITTLE BRIDGES CHILD CARE CENTER
FACILITY NUMBER: 073405614

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(a)(1)
Sign In and Sign Out
(a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/11/2022
Plan of Correction
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Director will ensure that all infants, 2 years and under, have a completed needs and services plan. upon completion of plans, Director will send LPA Pringle a copy of each completed for for all children in the Frogs classroom
Type B
Section Cited
CCR
101419.2(a)
Infant Needs and Services Plan
(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/06/2022
Plan of Correction
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Director will ensure that all children are properly signed in. Director will send copy of sign in/out log to LPA by POC date.
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:Jason Jang
LICENSING EVALUATOR NAME:Morgan Pringle
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2022


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