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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700740
Report Date: 08/01/2024
Date Signed: 08/01/2024 04:13:58 PM

Document Has Been Signed on 08/01/2024 04:13 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:BUILDING KIDZ SCHOOLFACILITY NUMBER:
435700740
ADMINISTRATOR/
DIRECTOR:		ALVAREZ, CYNTHIAFACILITY TYPE:
850
ADDRESS:569 SAN ANTONIO ROADTELEPHONE:
(650) 966-6400
CITY:PALO ALTOSTATE: CAZIP CODE:
94306
CAPACITY: 55TOTAL ENROLLED CHILDREN: 55CENSUS: 35DATE:
08/01/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:40 AM
MET WITH:Cynthia AlvarezTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 08/01/2024 at 10:40am, Licensing Program Analyst (LPA) Jialing “Julianne” Zhu and Licensing Program Manager (LPM) Chandra Charles met with Director Cynthia Alvarez for an unannounced annual inspection. Also present during the inspection were owner (Dibjot Gill), three (3) fingerprint-cleared staff, and 35 children in care. Upon arrival, LPA provided Director with a copy of the Entrance Checklist (LIC 125). The facility was toured to conduct a Health and Safety Inspection. The facility’s current hours of operation are Monday through Friday from 7:45am until 5:30pm.

Classrooms: This facility is a licensed preschool with a toddler component. The facility shares the campus with a school, Athena Academy. There are three (3) classrooms and a common space. The layout of the classrooms is open concept except for one classroom. All classrooms were inspected for age-appropriate furnishings, equipment, & adequate storage for children’s belongings. LPA observed the cleanliness of floors & surfaces, the presence of a fully functional carbon monoxide detector, smoke detectors/fire alarms, and fully charged 3A40BC fire extinguishers that are accessible throughout the facility. The smoke detectors were not tested today because the fire alarms can only be activated by the school, and they are not open today. The center is equipped with fully stocked first-aid kits and available in the classrooms. LPA inspected the napping equipment and observed them to be stored in a healthful manner. Children bring their own water bottles from home and can be filled at the facility. The isolation area is by the director’s desk.

Food Service Areas: All center provided food items are properly labeled & stored separately from cleaning supplies. Food prep area is clean, adequately equipped, & free from hazardous materials. Snack menus are posted and were reviewed. The facility provides AM/PM snacks, and children bring their own lunch from home. Solid waste bins are equipped with tight fitting lids.

Page 1 of 4. Seec LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2024
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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Document Has Been Signed on 08/01/2024 04:13 PM - It Cannot Be Edited


Created By: Jialing Zhu On 08/01/2024 at 03:07 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: BUILDING KIDZ SCHOOL
FACILITY NUMBER: 435700740

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as one (1) staff on premises did not obtain a fingerprint clearance prior to presence at the facility, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/02/2024
Plan of Correction
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Staff is to be removed from premises immediately until fingerprint clearance is obtained. Director will email written statement to confirm removal of staff from facility to jialing.zhu@dss.ca.gov by 08/02/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Chandra Charles
LICENSING EVALUATOR NAME:Jialing Zhu
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2024


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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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: BUILDING KIDZ SCHOOL
FACILITY NUMBER: 435700740
VISIT DATE: 08/01/2024
NARRATIVE
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Bathrooms: The bathrooms are located in a separate building across from the main classroom building. Toilets and faucets are in safe, sanitary, and operating condition. The children are able to reach the sinks, toilets, and supplies.

Outdoor Play Area: The outdoor play area is separated into multiple play area by fences. All equipment and surfaces are free from hazards. There is ample shade available. There are age-appropriate outdoor toys and materials for the children. The play structures are securely installed into the ground. The ground surrounding the play structures area sufficiently padded with sand or tanbark and in good condition. One play area is fenced, filled with sand, and is upkept on a weekly basis by a gardener. Drinking water is accessible by children outdoors. There are no bodies of water, or free-standing water accessible to children.

Records: All individuals subject to criminal record review have a clearance and/or exemption and have been associated to the facility except for one (1) staff who was recently hired on 07/08/2024. LPA reviewed six (6) children’s files and six (6) staff files. LPA reviewed the facility roster & personnel report and copies were obtained. At least one opening/closing staff member has a current Pediatric CPR/First-Aid Certification. Mandated Reporter certificates were reviewed. Director’s CPR/First-Aid Certificate is current and expires on 06/22/2026. Director was reminded of their responsibility to renew CPR/First Aid and Mandated Reporter certificates every two years. The center is in compliance with sign in and out procedures. Emergency Drills are performed at least every six months. The last Emergency Drill was conducted on 07/31/2024. Per director, there are no firearms on the premises. All required documents are posted in a publicly accessible area.

Record Keeping and Reporting Requirements: 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. Effective August 1, 2003 California Law requires Child Care Licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury Form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624, within seven (7) business days. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov.

Page 2 of 4. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
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Page: 5 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: BUILDING KIDZ SCHOOL
FACILITY NUMBER: 435700740
VISIT DATE: 08/01/2024
NARRATIVE
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Criminal Record Clearance: 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.

Lead Testing: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA referred director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

MyChildCarePlan.org: 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.

Incidental Medical Services (IMS): This facility does not currently provide Incidental Medical Services (IMS). 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/resources/child-care-centers/.

CCLD Information and Updates: 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.



Page 3 of 4. See LIC 809C.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: BUILDING KIDZ SCHOOL
FACILITY NUMBER: 435700740
VISIT DATE: 08/01/2024
NARRATIVE
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CCLD Inspection Process: 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.

Three (3) deficiencies and one (1) Advisory Notes were issued during today’s inspection. Please see attached advisory note pages for information on technical violations issued today. Note that technical violations are not citations but are advisory notes.

One (1) Type A Deficiency: One (1) staff did not obtain fingerprint clearance prior to presence at the facility.

Two (2) Type B Deficiencies: Infants (0-24 months old) did not have Needs & Services Plans; children from toddler component were in the same play area as children from preschool.

One (1) Technical Violation: Mandated Reporter training was expired for one (1) staff. Two (2) staff did not complete the correct Mandated Reporter training.

A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director Cynthia Alvarez. LPA provided director a copy of the Appeal Rights.

Page 4 of 4. End of Report.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 08/01/2024 04:13 PM - It Cannot Be Edited


Created By: Jialing Zhu On 08/01/2024 at 03:10 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: BUILDING KIDZ SCHOOL
FACILITY NUMBER: 435700740

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.2(a)
101419.2 Infant Needs and Services Plan (a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the Director did not comply with the section cited above as Infant Needs and Services plans are not kept for any enrolled infants (0-24 months of age), which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/30/2024
Plan of Correction
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Director will complete Infant Needs and Services Plans for all infants enrolled at the facility. Director will email 2 completed Infant Services Plans to LPA at jialing.zhu@dss.ca.gov by 08/30/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Chandra Charles
LICENSING EVALUATOR NAME:Jialing Zhu
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2024


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Document Has Been Signed on 08/01/2024 04:13 PM - It Cannot Be Edited


Created By: Jialing Zhu On 08/01/2024 at 03:41 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: BUILDING KIDZ SCHOOL
FACILITY NUMBER: 435700740

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.4
101216.4 Preschool Program with Toddler Component (a)(2) The toddler program shall be conducted in areas physically separate from those used by older or younger children... Plans to alternate use of outdoor play space must be approved by the Department.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the Director did not comply with the section cited above as children from toddler component were sharing the outdoor play space with children from the preschool at the same time, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/30/2024
Plan of Correction
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Director will email to LPA a written plan of how the children enrolled in the toddler component and children enrolled in the preschoool will be separated for outdoor play. The plan will be emailed to jialing.zhu@dss.ca.gov by 08/30/24.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Chandra Charles
LICENSING EVALUATOR NAME:Jialing Zhu
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2024


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