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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415072
Report Date: 04/21/2023
Date Signed: 04/21/2023 03:15:48 PM

Document Has Been Signed on 04/21/2023 03:15 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KIDS CHOICE AFTER SCHOOL CAREFACILITY NUMBER:
434415072
ADMINISTRATOR:LORENE SCATENAFACILITY TYPE:
840
ADDRESS:1711 STANFORD AVENUETELEPHONE:
(650) 656-8170
CITY:STANFORDSTATE: CAZIP CODE:
94305
CAPACITY: 84TOTAL ENROLLED CHILDREN: 84CENSUS: 32DATE:
04/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:04 PM
MET WITH:Lorene Scatena- DirectorTIME COMPLETED:
03:25 PM
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On 4/21/23, Licensing Program Analyst (LPA) Briana Plumboy arrived to the facility unannounced to conduct a REQUIRED 1 YEAR INSPECTION. LPA was met by Director, Lorene Scatena. Present during today's visit were 6 staff members and 32 school aged children. LPA conducted a health and safety inspection of the facility. Facility resides on LUCIELLE M. NIXON Elementary School Campus. The program is utilizing 2 portables on school grounds. Hours of operation are from MTTh 2:30PM-6PM, WF 1:15PM-6PM. The facility is exempt from measuring, bathroom, and isolation requirements.

Facility utilizes Nixon Elementary playground, blacktop and field for outdoor space. Facility understands not to commingle with Elementary School children. Drinking water is available inside and outside by way of water fountains and bottles brought from home. Menus are posted. A sample of the sign in and out logs were reviewed. Facility has a functioning carbon monoxide detector. All licensing required documents are posted. There are no pools, spas or other bodies of water accessible to children in care during today's inspection. Disinfectants and other dangerous items are kept inaccessible during today's inspection. Furniture and equipment were observed to be in good condition, free of sharp, loose, or pointed parts during today's inspection. Playground equipment was observed to be in good repair and free of hazards during today's inspection. Areas under high climbing equipment are cushioned with material that absorbs a fall. Toilets, hand washing stations are kept in safe and sanitary operating conditions during today's inspection. Food prep areas were kept clean, free of litter and rubbish during today's inspection. Storage containers for solid waste have tight-fitting covers that are kept on and in good repair. Fire/Evacuation Drill is documented and conducted at least once every six months with the last drill conducted on 3/30/23. Facility utilizes the office spaces in each room for isolation should a child fall ill while in care. LPA reviewed 4 children files and 3 staff files.
See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2023
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDS CHOICE AFTER SCHOOL CARE
FACILITY NUMBER: 434415072
VISIT DATE: 04/21/2023
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Director Lorene Scatena 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 per/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Reminder that all forms can be downloaded at all forms can be downloaded at www.ccld.ca.gov.

Incidental Medical Services (IMS) policy was discussed. This facility provides IMS to children in care. Facility is following IMS plan on file. When any changes to the IMS plan is made, an updated 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.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director Lorene Scatena.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2023
LIC809 (FAS) - (06/04)
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