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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010212123
Report Date: 01/09/2020
Date Signed: 01/09/2020 12:01:08 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:MUSTARD SEED PRESCHOOLFACILITY NUMBER:
010212123
ADMINISTRATOR:CANDACE MARTINEZFACILITY TYPE:
850
ADDRESS:1640 HOPKINS STREETTELEPHONE:
(510) 527-6627
CITY:BERKELEYSTATE: CAZIP CODE:
94707
CAPACITY:66CENSUS: 65DATE:
01/09/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Director Candace MartinezTIME COMPLETED:
12:30 PM
NARRATIVE
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On 01/09/2020, Licensing Program Analyst (LPA) Brittany Newton made an unannounced visit for the purpose of conducting a random annual inspection. LPA was met by Candace Martinez, the Director. There are 65 children present today in 4 classrooms with 14 staff, 11 of these children are in the toddler option program.

The facility was toured inside and out to conduct a Health and Safety Inspection. There are 4 classrooms the facility operates in, the classrooms are: Piglets (2 year olds), the Roo class (toddler option), Pooh Bears (3 year olds), and the Kangas (4-5 year olds). Facility has required forms posted including the waiver. The program has adequate developmentally appropriate toys and equipment for children in care. The yard was inspected and found to have toys, bikes for children, and sand for cushioning around the play structure. A faucet for drinking water is available outside. Ample toilet and sinks are available for children use. There are ample cubbies for storage of children's personal belongings. No hazards are observed anywhere during the visit. Sign-in and out sheets were reviewed. Facility has fire extinguishers, smoke alarm and carbon monoxide detector. The last fire drill was conducted October 2019. The facility has the following pets: fish, a gecko and two turtles. They are all in tanks in the classrooms. Facility has a chef that prepares snacks and meals daily. The menus are posted. LPA Newton reviewed kitchen area which was found clean and orderly. Food storage showed proper labels and dates. CPR and First Aid is current for staff members on site and expires 08/28/2020. LPA reviewed staff and children's file which were found in compliance.

Facility is reminded that ALL assistants, volunteers and frequent visitors 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.
Incidental Medical Services were discussed. The facility is not providing Incidental Medical Services (IMS) at this time, but has a plan in place if and when a child comes into care that requires medicine administration.
A personnel roster and child care roster was obtained.

Deficiencies were cited at this visit, please see LIC 809D for deficiencies cited. Due to one of the deficiencies being a Type A violation in relation to fingerprinting and criminal record clearance, a civil penalty of $200.00 was assessed today. 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 Candace Martinez.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany NewtonTELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020
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: MUSTARD SEED PRESCHOOL
FACILITY NUMBER: 010212123
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/09/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/10/2020
Section Cited

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Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not met as evidenced by:
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Based upon observation and record review, S1 does not have a criminal record clearance on file which poses an immediate Health, Safety, or Personal Rights risk to children in care.
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A civil penalty of $200.00 was assessed today. Failure to correct will result in a $100.00 per day civil penalty until corrected. Repeat Violations are $250.00 per violation and $100.00 per day until corrected.
Type B
01/10/2020
Section Cited

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Limitations on Capacity and Ambulatory Status. (a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement was not met as evidenced by:
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Based on observation of the toddler option program by LPA Newton, 11 toddlers were present with 3 staff, but the license allows 10 toddlers only. Having the additional child poses a potential Health, Safety, or Personal Rights risk to children in care.
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Failure to correct will result in a $100.00 per day civil penalty until corrected. Repeat Violations are $250.00 per violation and $100.00 per day until corrected.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany NewtonTELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:
DATE: 01/09/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2020
LIC809 (FAS) - (06/04)
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