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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010211122
Report Date: 05/04/2023
Date Signed: 05/04/2023 03:19:03 PM


Document Has Been Signed on 05/04/2023 03:19 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:MODEL SCHOOL COMPREHENSIVE HUMANISTIC LEARNING CTRFACILITY NUMBER:
010211122
ADMINISTRATOR:YVONNE STEENFACILITY TYPE:
830
ADDRESS:2330 PRINCE STREETTELEPHONE:
(510) 549-2711
CITY:BERKELEYSTATE: CAZIP CODE:
94705
CAPACITY:20CENSUS: 8DATE:
05/04/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Yvonne SteenTIME COMPLETED:
03:40 PM
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On 05/04/23, Licensing Program Analyst (LPA) Melissa Domantay arrived at the facility for an unannounced case management inspection for adding an infant room at the 2330 Prince Street Berkeley, Ca 94705 location. LPA met with Director, Yvonne Steen. Present for today's inspection were 8 infants and 4 staff. The normal hours of operation are Monday-Friday 7:00am-6:00pm. LPA conducted a tour of all the classrooms to conduct a health and safety inspection with Yvonne. 1 classroom, the Angelfish Classroom will be utilized for infant program along with separate outdoor infant play yard. All measurements remain the same from previous inspection.

Facility is pending updated fire clearance from the Oakland Fire Department for 20 infants, 36 preschoolers two years to first grade entry, and 14 toddlers, 18-36 months.

LPA observed that the classrooms has sufficient lighting and appears to be clean and in good condition. LPA observed an ample supply of age appropriate activities, equipment, furniture, and are equipped with varied age appropriate materials and equipment. Per Director Yvonne, there will be 7-9 cribs that will be set up in the infant classroom as needed for crib-aged infants. Director will provide photos of the crib area with barricade to LPA. The outdoor play areas are fully fenced and have ample supply of age appropriate activities, equipment, and furniture. There is sufficient cushion to absorb a child's fall under the play areas. LPA observed ample amount of shade for children. The building has fully charged 3A40BC fire extinguishers and first aid supplies. There is a working telephone at the center. LPA did not observe any hazardous items that would be accessible to children.

A license for a capacity of 20 infants is pending until updated fire clearance is received from Oakland Fire Department and photos of the crib area with barricade is provided to LPA by Director Yvonne. There are no deficiencies being cited today. A Notice of Site inspection was provided to Director, Yvonne Steen and an exit interview was conducted.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa DomantayTELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:
DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/04/2023
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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