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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407453
Report Date: 01/31/2024
Date Signed: 01/31/2024 12:57:21 PM

Document Has Been Signed on 01/31/2024 12:57 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:GRACIE'S PLACE PRESCHOOLFACILITY NUMBER:
073407453
ADMINISTRATOR:PLATTS, DENISEFACILITY TYPE:
850
ADDRESS:17011 BOLLINGER CANYON ROADTELEPHONE:
(925) 302-9092
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY: 13TOTAL ENROLLED CHILDREN: 19CENSUS: 7DATE:
01/31/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Denise PlattsTIME COMPLETED:
12:56 PM
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On 1/31/2024 at 11:05am Licensing Program Analyst (LPA) Morgan Pringle met with Owner/Director Denise Platts for an Unannounced Required 3-Year Inspection. Present during the inspection was the Director and seven (7) preschool age children. The facility operates inside the Dougherty Station Community Center in room 102 and uses the Ridgeview Room as an activity space. The facility operates from 9:00am – 1:00pm, Monday - Friday.

The facility has ample age-appropriate materials in the classroom that were observed to be clean and in good condition. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. The children’s bathroom was observed to be clean, well maintained, free of defects, and in proper working order. The diaper changing area was observed to be clean, properly padded, and free from defects. There is a fully charged fire extinguisher, carbon monoxide detector, smoke detector, and first aid kit on site. The facility does not transport children and the children do not nap. Children bring their own lunch, snacks and water bottle. Facility does not have an outdoor area and uses the Ridgeview room for activity space. Director has age-appropriate materials for the children that were observed to be well maintained and in proper working order.

The facility is operating within its licensed capacity and is in ratio. All staff working have obtained a criminal record clearance, exemption, or transfer. The fire/disaster drill log is complete with the last drill logged on 12/18/2023. A physical census of the children was taken and cross referenced with the sign-in and out log. All children have been signed in by their parent or authorized representative. All required postings are made visible in the back of the room next to the cubbies. LPA obtained a sample of the children’s files, and the facility files. All files were complete.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2024
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: GRACIE'S PLACE PRESCHOOL
FACILITY NUMBER: 073407453
VISIT DATE: 01/31/2024
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No deficiencies cited during LPAs inspection.

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. 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. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov.

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.

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

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
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: GRACIE'S PLACE PRESCHOOL
FACILITY NUMBER: 073407453
VISIT DATE: 01/31/2024
NARRATIVE
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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 the Director Denise Platts.

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

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC809 (FAS) - (06/04)
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