010205449-2-9-2023-02-CC-AWRT-CNW2YU-20230209164918

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010205449
Report Date: 02/09/2023
Date Signed: 02/09/2023 04:49:47 PM

Document Has Been Signed on 02/09/2023 04:49 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	LAKE SCHOOL (THE)		FACILITY NUMBER:	010205449
ADMINISTRATOR:	GALLO, MARIA		FACILITY TYPE:	850
ADDRESS:	304 LESTER AVENUE		TELEPHONE:	(510) 839-4227
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94606
CAPACITY: 46	TOTAL ENROLLED CHILDREN: 46	CENSUS:	DATE:	02/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Maria Gallo		TIME COMPLETED:	05:00 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	On February 9th, 2023 @1:30pm, Licensing Program Analyst (LPA) April Wright arrived for an unannounced Required-1 Year inspection, and met with director Maria Gallo. Present today were 12 children and 3 fingerprint cleared staff members present during the inspection. The facility is in ratio today. The facility was toured for a health and safety inspection. Hours of operation are Monday through Friday, 8:00am to 3:45pm. CLASSROOMS: Center has five (5) classrooms (Hummingbirds, Finch, Robin bird, Mallards and Blue Jays). There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting for safety and comfort. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is the director's office, away from other children in care. The center has smoke/carbon monoxide detectors, working telephone, and fully charged 3A40BC/5HISA40 ABC fire extinguishers in each classroom. At least one person trained in CPR/First aid is present when children are at the facility BATHROOMS: The staff's bathroom is separate from the children's bathrooms/classrooms and are clean, sanitary and in good condition. All sinks and faucets are in safe and in sanitary operating condition. . FOOD SERVICE AREAS: This facility has kitchen but does not supply food to children in care. Kitchen is used buy staff only and is inaccessible to children. All storage containers for solid waste have tight fitting covers that are in good repair. Facility has a refrigerator which is clean and free of evidence of rodents, vermin or insects. OUTDOOR PLAY AREAS: Front yard play structure with slide and sandbox with canopy that has cushioning to absorb falls and that is anchored for stability. Main play yard has play structure with dual slides and foam cushioning to absorb falls and that is anchored for stability. There are no pools, hot tubs or other accessible bodies of water. Per director there are no firearms or weapons present at the facility. See LIC809-C for continuance

Chandra Charles
April Wright
	DATE: 02/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LAKE SCHOOL (THE)	FACILITY NUMBER: 010205449
	VISIT DATE: 02/09/2023

NARRATIVE

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RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Six (6) children's files and three (3) staff files were reviewed, along with director's file. All staff files have required health screening and Employee Rights and all children files contain Identification & Emergency, Personal Rights, and Medical Consent forms. LPA reviewed the facility roster and obtained a copy. Mandated Reporter Training and CPR and First Aid certificates were reviewed and are up to date. The center is in compliance with the sign in and out procedure via Brightwheel. Disaster drills are being conducted at least once every 6 months and the last one conducted was on 1/18/2023. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: IMS IS AT THIS FACILITY. Medications/storage space were reviewed for three (3) children in care. 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

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/inspection-process .

Facility representative 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/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

See LIC809C for continuance..

SUPERVISOR'S NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LAKE SCHOOL (THE)	FACILITY NUMBER: 010205449
	VISIT DATE: 02/09/2023

NARRATIVE

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Deficiencies & Advisory Notes Issued Today: Please see attached Deficiency & Advisory Note pages for additional information.

Technical Violation(s): S3 is associated to facility but fingerprint clearance is pending document upload of 508 form per Guardian website.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Maria Gallo.

SUPERVISOR'S NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

LIC809 (FAS) - (06/04)

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