010209547-12-7-2023-52-CC-SCOZ-CYAPD3-20231207101254

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010209547
Report Date: 12/07/2023
Date Signed: 12/07/2023 10:13:24 AM

Document Has Been Signed on 12/07/2023 10:13 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	BETH SHOLOM PRESCHOOL		FACILITY NUMBER:	010209547
ADMINISTRATOR:	CHASE, AMANDA		FACILITY TYPE:	850
ADDRESS:	642 DOLORES AVENUE		TELEPHONE:	(510) 357-8505
CITY:	SAN LEANDRO	STATE: CA	ZIP CODE:	94577
CAPACITY:	49	CENSUS: 39	DATE:	12/07/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:24 AM
MET WITH:	Amanda Chase		TIME COMPLETED:	12:17 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 12/07/2023, Licensing Program Analyst (LPA) Sidney Cortez conducted an UNANNOUNCED ANNUAL REQUIRED INSPECTION for Beth Sholom Preschool. Present for the inspection were the Director and 9 teachers who are all fingerprint cleared. The total children enrolled are 40 and the census was 37 children at the time of the inspection. The Child Care Center is within ratio. The center is opened Monday through Friday from 7:30am to 5:30pm. The Child Care Center was toured to conduct a Health and Safety Inspection. PHYSICAL PLANT: The entrance of the school is a door which leads to the entrance of the classrooms. The parents sign in and out using an app called Bright Wheel. There are 3 classrooms at the center. There are two toilets that are in operable condition for children to use. The classrooms have cubbies with children’s names on them where personal items can be placed. The classrooms have chairs and tables equipped for children to use. The isolation area is the Director’s office. LPA observed the bulletin board (parent’s rights, emergency disaster plan, earthquake drills and facility license). All hazardous materials and toxins are kept out of reach from children and are not accessible. There is a fire extinguisher 3A 10 40 BC. There are multiple working smoke detectors, one carbon monoxide detector, a telephone and a fully stocked first aid kits. The furniture around the classroom and outdoor area are all child proof and adequate for children to use. The learning materials are organized, and toys are kept in safety bins and cabinets for easy access for the children. FOOD & SNACK: The school does not provide food. The children bring food and water from home. The teachers have a pitcher of water in the classroom to refill the water bottles.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sidney Cortez	TELEPHONE: (510) 295-5031
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: BETH SHOLOM PRESCHOOL	FACILITY NUMBER: 010209547
	VISIT DATE: 12/07/2023

NARRATIVE

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OUTDOOR: LPA Dodoo observed the outdoor area that has a play structure with a slide. There is tan bark all around the play structure to absorb falls. The outdoor play area is also fenced all around with secured gates. There are no bodies of water on the premises. There are no firearms on premises.

RECORDS: LPA reviewed 6 children’s files and 7 staff files(Director included) and documented them on LIC 859 and LIC 857. An updated roster was viewed by LPA. The Director and staff have completed the Health and Safety training and CPR/First Aid is current. The Director and Staff are following the immunization laws and have completed the mandated reporter training. The Director has conducted and documented the fire and disaster drills twice a year and the last conducted drill was Nov 1, 2023. All required forms are posted and visible for public view.

Incidental Medical Services (IMS) policy was discussed. This facility is providing IMS (Incidental Medical Services) to children currently in care. LPA reviewed medication that is stored in bag locked away and is unexpired. If any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Director was reminded that all adults 18 and over working in Child Care Center, 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 licensed 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.

There are no deficiencies cited during today’s inspection. A notice of site visit was given and must remain posted for 30 days. Exit Interview was conducted with Director. This report shall remain on file for the next 3 years.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sidney Cortez	TELEPHONE: (510) 295-5031
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

LIC809 (FAS) - (06/04)

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