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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408880
Report Date: 06/12/2023
Date Signed: 06/12/2023 07:01:25 PM

Document Has Been Signed on 06/12/2023 07:01 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:GARDEN COMMUNITY PRESCHOOL, THEFACILITY NUMBER:
073408880
ADMINISTRATOR:CADY, MELISSAFACILITY TYPE:
850
ADDRESS:1015 OAK GROVE ROADTELEPHONE:
(925) 671-2979
CITY:CONCORDSTATE: CAZIP CODE:
94518
CAPACITY: 39TOTAL ENROLLED CHILDREN: 39CENSUS: 30DATE:
06/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:MELISSA CADYTIME COMPLETED:
06:45 PM
NARRATIVE
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LICENSING PROGRAM ANALYST TASHA ALEXANDER MET TODAY WITH CENTER DIRECTOR HALEY DAUGHRITY FOR AN UNANNOUNCED 1 YEAR/REQUIRED INSPECTION. UPON ARRIVAL THERE ARE 30 PRESCHOOL AGE CHILDREN PRESENT ALONG WITH 7 STAFF MEMBERS. THE DIRECTOR DIRECTOR IS NOT INCLUDED IN THE RATIOS TODAY. TODAY THE CLASSROOMS 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 ASIDE FROM THE CUSHIONING IN THE PLAY STRUCTURE AREA THAT HAS CRACKS/SEPARATING AND EXPOSING THE CEMENT/ROCK UNDERNEATH. DISINFECTANTS, CLEANING SOLUTIONS, POISONS AND OTHER ITEMS THAT ARE DANGEROUS TO CHILDREN WERE INACCESSIBLE DURING TODAY'S .INSPECTION. THE SINKS WERE OBSERVED TO BE IN OPERABLE CONDITION. THE FLOORS ARE FREE OF TRIPPING HAZARDS. THE FACILITY PROVIDES AM/PM SNACKS ARE PROVIDED BY THE FACILITY. A WEEKLY SNACK MENU IS POSTED 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 OUTDOORS. CHILDREN BRING THEIR OWN WATER BOTTLES OUTDOORS. THE OUTDOOR ACTIVITY SPACE AND PLAYGROUND EQUIPMENT WAS OBSERVED TO BE SAFE. THE MATERIAL UNDER THE PLAY STRUCTURE THAT ABSORBS FALLS HAS CRACKS/SEPARATING WHICH IS EXPOSING THE CEMENT/ROCKS UNDERNEATH. THERE ARE CANOPIES/TREES 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: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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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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: GARDEN COMMUNITY PRESCHOOL, THE
FACILITY NUMBER: 073408880
VISIT DATE: 06/12/2023
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: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
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: GARDEN COMMUNITY PRESCHOOL, THE
FACILITY NUMBER: 073408880
VISIT DATE: 06/12/2023
NARRATIVE
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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: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 06/12/2023 07:01 PM - It Cannot Be Edited


Created By: Tasha Hackett-Alexander On 06/12/2023 at 06:16 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: GARDEN COMMUNITY PRESCHOOL, THE
FACILITY NUMBER: 073408880

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2023

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. TODAY THERE ARE SEVERAL STAFF THAT DO NOT HAVE IMMUNIZATION RECORDS IN FILE OR ARE MISSING THE FLU VACCINE/DECLARATION OR PROOF OF MMR VACCINE
POC Due Date: 06/26/2023
Plan of Correction
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LICENSEE WILL HAVE EACH STAFF MEMBER OBTAIN THEIR IMMUNIZATION RECORDS. LICENSEE WILL SUBMIT COPIES OF THE RECORDS TO COMMUNITY CARE LICENSING BY 6/26/23
Type B
Section Cited
HSC
1596.8662(c)
Administration of Child Day Care Licensing
(c) Current proof of completion for each licensed child day care provider or applicant for that license, administrator, and employee of a licensed child day care facility shall be submitted to the department upon inspection of the child day care or upon request by the department.

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. TODAY A REVIEW OF RECORDS SHOWS STAFF EITHER DO NOT HAVE THE MANDATED REPORTER CERTIFICATE IN FILE OR THE CERTIFICATE HAS EXPIRED.
POC Due Date: 06/26/2023
Plan of Correction
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LICENSEE WILL HAVE STAFF UPDATE THE MANDATED REPORTER TRAINING AND SUBMIT COPIES OF THE UPDATED CERTIFICATES TO COMMUNITY CARE LICENSING BY 6/26/23.
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: 06/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/12/2023 07:01 PM - It Cannot Be Edited


Created By: Tasha Hackett-Alexander On 06/12/2023 at 06:16 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: GARDEN COMMUNITY PRESCHOOL, THE
FACILITY NUMBER: 073408880

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101215.1(m)
Child Care Center Director Qualifications and Duties
(m) A child care center director shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866.

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. TODAY THE CENTER DIRECTOR IS UNABLE TO LOCATE HER HEALTH & SAFETY CERTIFICATE
POC Due Date: 06/26/2023
Plan of Correction
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LICENSEE WILL LOCATE HER HEALTH & SAFETY CERTIFICATE AND SUBMIT A COPY OF THE CERTIFICATE TO COMMUNITY CARE LICENSING BY 6/26/23.
Type B
Section Cited
CCR
101216(l)(1)(B)
Personnel Requirements
(B) A copy of the signed LIC 9052 (11/94) shall be kept in the employee's personnel record.

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. TODAY THERE IS ONE STAFF MEMBER THAT DOES NOT HAVE THE SIGNED EMPLOYEE RIGHTS RECEIPT IN FILE.
POC Due Date: 06/26/2023
Plan of Correction
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LCIENSEE WILL HAVE THE STAFF MEMBER SIGN THE EMPLOYEE RIGHTS FORM AND SUBMIT A COPY OF THE RECEIPT TO COMMUNITY CARE LICENSING BY 6/26/23
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: 06/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2023


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