010211169-6-24-2019-02-CC-SNEN-BDFRY5-20190624132546

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010211169
Report Date: 06/24/2019
Date Signed: 06/24/2019 01:25:53 PM

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:	CORNERSTONE CHILDREN'S CENTER		FACILITY NUMBER:	010211169
ADMINISTRATOR:	GRAY, TARA		FACILITY TYPE:	830
ADDRESS:	2407 DANA STREET		TELEPHONE:	(510) 280-6126
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94704
CAPACITY:	40	CENSUS: 30	DATE:	06/24/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Tara Gray		TIME COMPLETED:	01:40 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	An unannounced Annual/Random site visit was conducted by LPA Susan Neeson. Met with Tara Gray, Director. There are 10 staff present and 30 children. All staff are fingerprint clear and associated with the facility. Ratio of 1:4 was met throughout the visit. All infant staff have current CPR and First Aid certification. All infant staff have required immunizations. The facility was toured. No hazards are observed in the facility. Changing areas were observed. Staff were observed changing children. Universal precautions were followed. Toys and equipment are in good condition. The school provides sheets and blankets for use in napping and they are washed every day. There is a first aid kit in every classroom. There is one in the playground. Additionally, there is a backpack with first aid supplies for use in emergencies or field trip. Sign-in and out forms were reviewed. The parents provide all food for the infants. The youngest infants have a separate nap room in which every crib is marked with their name. The older children sleep in a crib that is sanitized every day and has fresh bedding every time it is used. Infant needs and services plans are updated quarterly. Children's records are being maintained. Roster is current. Licensee 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. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov and for day care updates visit www.myccl.ca.gov

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan Neeson	TELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: CORNERSTONE CHILDREN'S CENTER	FACILITY NUMBER: 010211169
	VISIT DATE: 06/24/2019

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
26
27
28
29
30
31
32

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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 Copy of IMS Plan of Operation is in file.

Documents issued during visit: CCLD Quarterly Updates for Winter 2019 and Spring 2019; AB 1207 information; Fir/earthquake drill form and information; Car Seat safety information; Safe sleep for infants, Safe and Healthy Diapering and Licensee Rights.

No deficiencies are observed. An exit interview was given,

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan Neeson	TELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2