Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073403723
Report Date: 05/28/2015 12:00:00 AM
Date Signed 05/28/2015 02:01:36 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:AIM-HIGH CHILD CARE - KREYFACILITY NUMBER:
073403723
ADMINISTRATOR:OLVEDA, ANTOINETTEFACILITY TYPE:
840
ADDRESS:190 CRAWFORD DRIVETELEPHONE:
(925) 516-1760
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:60CENSUS: 6DATE:
05/28/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Antoinette Olveda- Ramos, DirectorTIME COMPLETED:
02:25 PM
NARRATIVE
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(2) LPA Anika Evans met with Director Antoinette Olveda- Ramos for the purpose of an unannounced annual random visit. This facility is located on the campus of Krey Elementary school. there were 6 children present during this visit that were initially napping. LPA conducted a health and safety inspection of the facility.
Physical Plant: there were no pools spas on the premises. There were no firearms on the facility grounds. There is a fully stocked first aide kit available if children become injured. The play ground used is right next to the building and it has proper cushioning and all climbing equipment is properly anchored to the ground. There were no toxins stored with food. There were ample tight fitted lid waste cans in the facility. There is drinking water readily available in and out doors of the facility. There was no standing water in the restrooms and all had ample paper towels and liquid soap for children's use. There were no hazards found outside of the facility. There was no evidence of Rodents or vermin in the facility. FACILITY ADMINISTRATION: LPA was granted entry to the facility upon arrival. All staff present today were fingerprint cleared and associated to this facility. The licensee was operating within the capacity limits. There is at least one person with current CPR/First Aide on the grounds. The sign in and out sheet was reviewed and cross referenced with the children present and matched. Directors CPR and First Aide expire 2016. EVALUATION of CARE and SUPERVISION: All children were supervised during this visit and no personal rights being violated. All children were treated with dignity and respect. Facility was operating within the proper child teacher ratio during this visit, FACILITY RECORDS REVIEW: A random census of children's records and staff records was reviewed and found to have all proper documentation in them with emergency information for children and with education proof in staff files.

The attached type B deficiency is cited today and must be corrected by the due dates. Appeal rights were given and discussed. This report must be available for public review for 3 years. An exit interview was conducted with director, Antoinette Olveda-Ramos, and a site visit notice was posted and must remain posted for a period of 30 days for public review.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Anika EvansTELEPHONE: (510) 622-2626
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2015
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: AIM-HIGH CHILD CARE - KREY
FACILITY NUMBER: 073403723
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/28/2015
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/28/2015
Section Cited
101238(g)
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101238(g) Buildings and Grounds. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children shall be inaccessible to children.
Today upon health and safety inspection LPA saw a container/bucket on the counter labeled bleach that was filled with a bleach and a water solution that was accessible to children in care. Children initially were napping but during the visit they got up which made this a possible risk to their health and safety
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This was immediately corrected by pouring the water out of the container/bucket. LPA had a brief consultation with the director reminding her to remind staff that once dishes have been washed in such as solution this water should be discarded as there can be no standing water especially with cleaning solutions accessible to children.,
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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: Diane PerezTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Anika EvansTELEPHONE: (510) 622-2626
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2015
LIC809 (FAS) - (06/04)
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