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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010211849
Report Date: 05/23/2023
Date Signed: 05/23/2023 03:13:54 PM


Document Has Been Signed on 05/23/2023 03:13 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:ELMHURST DAY CARE & PRE-SCHOOLFACILITY NUMBER:
010211849
ADMINISTRATOR:ESCOTO, MARILYNFACILITY TYPE:
840
ADDRESS:380 ELMHURST STREETTELEPHONE:
(510) 786-1289
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY:40CENSUS: 18DATE:
05/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Marilyn EscotoTIME COMPLETED:
03:15 PM
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On May 23, 2023 at 11:00 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced Annual Required Inspection and met with the facility representative, Marilyn Escoto. LPA disclosed the purpose of the inspection and was granted entry into the facility by the facility representative. There were 18 school age children present during this inspection and two (2) additional staff members. The facility consists of one classroom. This center has a preschool component license number #010210079. The facility was toured inside and out for a health and safety inspection. The hours of operation are 6:30 AM-6:00 PM, Monday -Friday

LPA checked the facility RECORDS and they show all individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. LPA conducted a census of the children and the census matches the children signed in on the sign in sheet.

LPA reviewed two (2) children's files and two (2) staff files around 1:00 PM. All staff files have required Health Screening, and Employee Rights, and all children files contains Personal Rights, Medical Consent forms, and Identification & Emergency Information. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed, and certificates were reviewed.

The one (1) classroom was inspected around 1:30 PM and teacher-child ratio was observed. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is in the director's office, away from other children in care. The center has a working smoke detectors, a carbon monoxide detector, working telephone, and fully charged 3A40BC fire extinguishers which meets standards established by the State Fire Marshal throughout the facility. Disaster drills are being conducted at least once every 6 months and the last one conducted was on 01/30/2023. All required documents are posted in a public accessible area.



See 809-C.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:
DATE: 05/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2023
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 3


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: ELMHURST DAY CARE & PRE-SCHOOL
FACILITY NUMBER: 010211849
VISIT DATE: 05/23/2023
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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

There's no IMS being provided at this time and no medication being stored at the facility. The center is equipped with a fully stocked first aid kit that is available in the classroom.



This facility provides breakfast, lunch, and snacks for the children. There are weekly menus posted at the facility. LPA observed the kitchen area where they have a refrigerator this area is clean and free of evidence of rodents. Food is protected from contamination and, per staff, contaminated food is discarded immediately. Food/beverages capable of rapid spoiling are properly stored. Pesticides and other similar toxic substances are not stored in cabinets that contains food. All storage containers for solid waste have tight fitting covers that are in good repair.

The outdoor area has a play structure with a slide that has cushioning to absorb falls. There's also a swing set that is anchored with cushioning. There are multiple canopies that provides shade to children while at play. The staff brings the children’s water bottles and cups to keep the children hydrated while on the playground. The play equipment is age appropriate and in good repair. The playground is fully fenced with two sheds that are locked an inaccessible to children that stores equipment and files.



The children's bathroom is separate from the staff's bathroom and all of the sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets and the paper towels and soap are available to the children.

California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

See 809-C

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023
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: ELMHURST DAY CARE & PRE-SCHOOL
FACILITY NUMBER: 010211849
VISIT DATE: 05/23/2023
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LPA discussed the safe sleep regulations with facility representative 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 facility representative 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.

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.

Facility representative 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.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Marilyn Escoto.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023
LIC809 (FAS) - (06/04)
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