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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406688
Report Date: 10/03/2022
Date Signed: 10/03/2022 12:52:23 PM

Document Has Been Signed on 10/03/2022 12:52 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:PITTSBURG USD - LOS MEDANOS STATE PRESHOOLFACILITY NUMBER:
073406688
ADMINISTRATOR:TUTT, PHYLLISFACILITY TYPE:
850
ADDRESS:610 CROWLEY AVETELEPHONE:
(925) 473-2300
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY: 24TOTAL ENROLLED CHILDREN: 26CENSUS: 15DATE:
10/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Laura SerratosTIME COMPLETED:
12:55 PM
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On 10/3/22 at 9:50 AM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Annual Inspection at Los Medanos State Preschool, which is located on Los Medanos Elementary School campus. LPA met with Lead Teacher, Laura Serratos and explained the purpose of today's inspection. LPA was granted inspection authority to enter the facility. The facility was toured to conduct a Health and Safety Inspection. Facility's operating days and hours are Monday to Friday AM Group is 8AM-11AM and PM Group is 11:45AM-2:45PM.

Lead Teacher 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.

The physical plant was inspected. Facility operates in 1 Classroom
Room 101: 1 teacher and 1 aid with 15 children
Facility was observed to be in compliance with teacher to children ratio requirement during LPA’s inspection. The classroom, restroom and spaces accessible to children were inspected. Disinfectants, cleaning solutions, poisons and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children were observed, all toilets, hand washing are safe and sanitary operating condition. All floors were clean and safe. Food storage area were clean, free of litter, rubbish, and free of rodents and other vermin.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2022
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: PITTSBURG USD - LOS MEDANOS STATE PRESHOOL
FACILITY NUMBER: 073406688
VISIT DATE: 10/03/2022
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LPA observed Fire extinguisher, Smoke and Carbon Monoxide Detectors. All materials and surfaces accessible to children appeared to be toxic free. Menus were observed to be posted at least 1 week in advance in a place visible by the child’s authorized representative, dated and kept on file for 30 days and made available upon request.

Outdoor Space: Outdoor playground was inspected and observed to be fenced and safe. The play equipment was maintained in good condition and free of hazards. Surface of the outdoor activity space was in safe condition and free of hazards. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were no bodies of water observed. Drinking water is readily available to children during indoor and outdoor activities.

File Review: Children sign in and out procedures and logs were reviewed. All children were signed in by their authorized representative with full legal signatures. A sample of five (5) Children's files and two (2) Staff files was taken for review.

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. When any IMS is provided, an updated Plan of Operation that includes 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

There are no deficiency cited during today's inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Lead Teacher.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
LIC809 (FAS) - (06/04)
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