010206158-4-5-2022-02-CC-DCAS-CCUUN9-20220325154334

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010206158
Report Date: 03/25/2022
Date Signed: 04/05/2022 08:45:25 AM

Document Has Been Signed on 04/05/2022 08:45 AM - It Cannot Be Edited

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:	BOOTH MEMORIAL DAY CARE		FACILITY NUMBER:	010206158
ADMINISTRATOR:	CRAWFORD, BRIDGETT		FACILITY TYPE:	850
ADDRESS:	2794 GARDEN STREET		TELEPHONE:	(510) 535-5088
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 34	DATE:	03/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:38 AM
MET WITH:	Huong Huynh		TIME COMPLETED:	03:55 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 3/25/2022 at 8:38am Licensing Program Analyst (LPA) Diana Campos arrived at facility to conduct an unannounced annual required inspection. LPA met with Site Supervisor, Huong Huynh, and began a tour of all areas of the facility used by children in care for a health and safety inspection. Present during this inspection were 36 children in care consisting of 12 toddlers, and 24 preschoolers and 9 staff. The facility and each classroom is within ratio and capacity. Supervision is being provided for all children present. Per site supervisor, there are no firearms present or stored on the premises. Classrooms A, B, C, and D were inspected including furnishings and equipment for age appropriateness and absence of broken/sharp pieces. Toddler component classrooms are separate from the older children classroom and toddlers do not commingle with the older children. Counter tops and surfaces are free of toxins. Hazardous items are kept inaccessible to children in care via locked doors and on shelves out of the reach of children in care. Children have individual storage cubbies for their personal belongings in all classrooms and drinking water is available indoors and outdoors via individual sippy cups and water coolers. The facility has centralized smoke detectors/fire alarm system as well as working carbon monoxide detector. Multiple fully charged fire extinguishers are present. Per Site supervisor, the most recent fire department inspection for this facility was within the past six months. There is heating and ventilation available for temperature management. Napping cots and linens are stored individually. Per staff linens are sent home to be laundered weekly. Breakfast, lunch and snacks are provided by the Salvation Army kitchen located next door to facility and picked up daily and served by staff. Menus are posted for public review. LPA inspected the food preparation and storage areas which is kept clean and appears free of pests. The outdoor play areas are fully fenced with a variety of age appropriate play equipment present. The high climbing equipment/slides has appropriate cushioning under and around the equipment and is securely anchored. There are no pools, hot tubs or other accessible bodies of water present. Per Site Supervisor the separate grassy outdoor area is not currently used by children in care as it is currently undergoing restructure/repair. Site Supervisor was reminded to contact LPA to inspect the area prior to use by children in care. LPA inspected the facility, staff, and children's files including sign in/out sheets, staff background clearances, and qualifications. -----------------------------------Continued on LIC809C---------------------------------------------------

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022

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: BOOTH MEMORIAL DAY CARE	FACILITY NUMBER: 010206158
	VISIT DATE: 03/25/2022

NARRATIVE

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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/process
Center Director 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.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Center Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

No deficiencies were cited during today's inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Center Director Bridgett Crawford.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022

LIC809 (FAS) - (06/04)

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