Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010212832
Report Date: 11/02/2016
Date Signed 11/02/2016 04:19:14 PM

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:KIDS CARE PLUS - STANTONFACILITY NUMBER:
010212832
ADMINISTRATOR:ENGBROCK, MICHELLEFACILITY TYPE:
840
ADDRESS:2644 SOMERSET AVE. + PORTABLE.TELEPHONE:
(510) 733-0775
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY:85CENSUS: 9DATE:
11/02/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Denise LudkeTIME COMPLETED:
04:35 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Wynn Norona met with center director, Denise Ludke for an unannounced ANNUAL/RANDOM visit. The center was toured inside and out for health and safety inspection. There are 9 school-age children with 3 fingerprint cleared staffs present today. The center is located on the far back end of Stanton Elementary School.

PHYSICAL PLANT: The facility appears to be safe, sanitary and in good repair. All the cleaning products and medicines were stored and made inaccessible to the children. Furniture and playground equipment are in good condition and free of hazards. The bathroom was toured and toilets flush properly and all faucets are in working order. The kitchen is not accessible to children in care. The food preparation area and storage areas are clean and in sanitary condition. There is a menu posted and there are no cleaning supplies stored with food. Snacks are provided by the center. There is a variety of snacks available for children. Drinking water is available both indoors and outdoors. The facility has a carbon monoxide detector. LPA inspected and verified that there are fire extinguishers all throughout the facility and first aid kit is fully stocked. INSPECTION of OUTDOOR PLAY AREA: Playground equipment is in good condition and outdoor activity space is maintained in a safe condition and free of any hazards. Climbing equipment is properly anchored to the ground with adequate and appropriate cushioning material to absorb falls. There is a shaded area provided for the children as well. RECORD REVIEWS: A physical census was taken of all children present and crossed referenced with the sign in and out sheets. LPA reviewed children’s and staffs records including immunization. Opening and closing staff have current CPR and first aid training. POSTING REQUIREMENTS: License and other relevant notices are visible for public views and correctly posted on the wall. Fire and disaster drills are being conducted as scheduled every six months.

--------------------------------------------- CONTINUED ON PAGE 2-----------------------------------------------------------------

SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Wynn NoronaTELEPHONE: 510-542-4257
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2016
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2


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: KIDS CARE PLUS - STANTON
FACILITY NUMBER: 010212832
VISIT DATE: 11/02/2016
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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)/ (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

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates. Assembly Bill 633 Fact Sheet was given and discussed with the director.



There are no deficiencies cited today. Exit interview was conducted with the executive director, Annaleza Roque. The director was provided a copy of the appeal rights and the signature on this form acknowledges receipt of these rights.

Notice of Site visit was posted at the time of inspection and must remain posted for 30 days.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Wynn NoronaTELEPHONE: 510-542-4257
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2016
LIC809 (FAS) - (06/04)
Page: 2 of 2