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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409590
Report Date: 06/19/2024
Date Signed: 06/19/2024 11:57:06 AM

Document Has Been Signed on 06/19/2024 11:57 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:GRACE CHILDCARE CENTER / GRACE ARMS OF ANTIOCHFACILITY NUMBER:
073409590
ADMINISTRATOR/
DIRECTOR:		BEATE BELLFACILITY TYPE:
860
ADDRESS:3415 OAKLEY RDTELEPHONE:
(925) 522-2017
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 29TOTAL ENROLLED CHILDREN: 29CENSUS: 0DATE:
06/19/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Kirkland SmithTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) M. Domantay and Christina Watts met with Applicant Kirkland Smith for the purpose of a pre-licensing inspection. Applicant requests a single licensed child care center for a Preschool program ages 2 years to first grade entry license to serve a total of 29 children. The program will operate Monday through Friday from 7:00 a.m. to 6:00 p.m. The fire clearance was granted and received on 2/14/2024 from the Contra Costa Fire Protection Department with occupancy code I-4. The facility will provide 2 snacks and lunch will be provided by families from home. LPAs reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

INDOOR ACTIVITY SPACE:
There are 3 indoor areas for the Preschool program: Room 1 (Duckie Room), Room 2 (Panda Room), and Room 3 (Tiger Room). LPAs observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping mats. There is a first aid kit on the wall of each classroom entrance of the facility. Medications will be stored in the Director's office in a locked cabinet. LPAs observed cleaning disinfectants are appropriately stored and inaccessible to children in the staff restroom that will be locked. Applicant stated there are no poisons or firearms on the premises. LPAs observed a combination carbon monoxide detector in facility. LPAs observed a manual sign-in/sign-out system.

LPA measured all classrooms for the Preschool program. The total classroom space for the Preschool classroom contains a total of 733.79 square feet, which will not accommodate Applicant's request for 29 preschool children. There is a changing table in Room 1 that is in hands reach of a sink. There are 5 toilets and 4 sinks for the children, and two separate private restrooms for the staff which is located in the facility. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

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SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2024
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: GRACE CHILDCARE CENTER / GRACE ARMS OF ANTIOCH
FACILITY NUMBER: 073409590
VISIT DATE: 06/19/2024
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OUTDOOR ACTIVITY SPACE:
Outdoor area was not measured due to renovations still being done. LPAs notified Applicant and Director that outdoor play yard must be completed in order to be measured and shading must be installed.

LPA discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Applicant was informed of the MyChildCarePlan.org site, 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: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: GRACE CHILDCARE CENTER / GRACE ARMS OF ANTIOCH
FACILITY NUMBER: 073409590
VISIT DATE: 06/19/2024
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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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) or (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

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 platform. 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.

Exit interview conducted and report was reviewed with the Applicant, Kirkland Smith.

The following items are required before a license will be issued:

1. Licensing Program Manager (LPM) final file review.

2. Outdoor play yard shading must be installed.

3. Outdoor play yard renovations must be completed and measured by LPA.

4. Barrier between parking lot area and surrounded modular must be installed to secure walk way/entrance to outdoor preschool play yard.


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SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
LIC809 (FAS) - (06/04)
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