010211122-2-25-2020-02-CC-BNEN-BM5QC6-20200225110238

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010211122
Report Date: 02/25/2020
Date Signed: 02/25/2020 11:02:54 AM

COMPREHENSIVE INSPECTION

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:	MODEL SCHOOL COMPREHENSIVE HUMANISTIC LEARNING CTR		FACILITY NUMBER:	010211122
ADMINISTRATOR:	MANTE, DAISY L.		FACILITY TYPE:	830
ADDRESS:	2330 PRINCE STREET		TELEPHONE:	(510) 549-2711
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94705
CAPACITY:	20	CENSUS: 13	DATE:	02/25/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Daisy Mante		TIME COMPLETED:	11:15 AM

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On 02/25/2020 Licensing Program Analyst (LPA) Brittany Newton made an unannounced required inspection at the above facility. LPA was met by director Daisy Mante. Present for the inspection was five infants with two teachers, and 8 toddlers with four teachers.
A tour of the facility was done for a health and safety inspection. Both Classrooms and yards were inspected. Shade is available on the yard. There is adequate age appropriate equipment and toys available for children in the classrooms. There is a changing table in a separate room with a sink. Inspection of changing table was found free of hazards or toxins. There is a refrigerator in each room with individual containers for each child's food or bottles. Storage of bottles was found in compliance with labels for each child. There is also individual storage bins for the children. There is a full kitchen that is mainly for staff. The refrigerator in the Toddler room has the snack for children. Drinking water is available inside and out via a pitcher and cups. Outdoor play area was found free of hazards with age appropriate toys. One fully charged 2A10BC fire extinguisher and two 3A40BC fire extinguishers were observed. A first aid kit was available on site. Fire drills have been being conducted with the last one being October 2019. First aid and CPR is current for staff on site, expiring 02/2021. LPA reviewed staff and children files which were found in compliance.

Individual Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. Currently, the facility doesn’t have kids in care requiring medicine. 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.

Facility is reminded that ALL assistants, volunteers, frequent visitors, or adults that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Facility was reminded of the responsibility as a mandated reporter and the requirement to complete the training every 2 years.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany Newton	TELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

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: MODEL SCHOOL COMPREHENSIVE HUMANISTIC LEARNING CTR	FACILITY NUMBER: 010211122
	VISIT DATE: 02/25/2020

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A child care roster and personnel report was obtained. The Licensee was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet and LPA discussed safe sleep practices.

No deficiencies observed at this visit. A Notice of Site visit was given and facility was reminded that it is required to be posted for 30 days. Exit interview conducted, appeal rights provided, and a copy of this report was left with Director Daisy Mante.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany Newton	TELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC809 (FAS) - (06/04)

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