010212123-8-2-2023-02-CC-ILOA-CUBTFN-20230802144149

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010212123
Report Date: 08/02/2023
Date Signed: 08/02/2023 02:42:02 PM

Document Has Been Signed on 08/02/2023 02:42 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:	MUSTARD SEED PRESCHOOL		FACILITY NUMBER:	010212123
ADMINISTRATOR:	CANDACE MARTINEZ		FACILITY TYPE:	850
ADDRESS:	1640 HOPKINS STREET		TELEPHONE:	(510) 527-6627
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94707
CAPACITY:	66	CENSUS: 53	DATE:	08/02/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:22 AM
MET WITH:	Candace Martinez		TIME COMPLETED:	02:49 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	On August 2, 2023 at 11:22am Licensing Program Analyst (LPA) Indira Loza met with Director Candace Martinez for an unannounced 1-year required visit. Present for the inspection, the were 53 children and 12 fingerprint cleared staff. During today's visit the LPA collected a children's roster. The facility was toured for a health and safety check. The hours of operation are 8am - 5:30pm, Monday - Friday CLASSROOMS: The preschool operates out five classrooms which were inspected. There were play and learning materials available for the children. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. There is proper individual storage space for each child. The center has a smoke detector, a carbon monoxide detector, working telephone, pull down fire alarm system, and a fully charged 3A40BC fire extinguisher. FOOD SERVICE AREAS: This facility provides a morning snack, lunch, and two afternoon snacks. LPA observed the kitchen to be clean and free from debris, combustibles, and chemicals. The center has completed the required lead testing of the water used for drinking and food preparation, there were no exceedances. The drinking water is available inside and outside of the center in pitchers filled with tap water. The children bring their own water bottles from home. OUTDOOR PLAY AREAS: LPA observed an anchored play structure with cushioning to absorb falls. There were plenty of age appropriate activities to promote gross motor skills. There were enough activities and space for the children to play comfortably. BATHROOMS AND TOILETING AREAS: This facility has separate bathrooms for the children and the staff. The sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets. There were supplies available to the children. ISOLATION AREA: The Director's office is the isolation area. RECORDS: All but one adults who are subject to criminal record review have a clearance or exemption. Mandated Reporter Training was current for all staff. All staff had a current CPR training certificate which expires on August 17, 2024. The last fire/disaster drill was conducted on October 21, 2022. All required documents are posted in a publicly accessible area. All children files were complete, except for the Infant ****************************Report Continues on LIC 809-C***********************

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

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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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
	VISIT DATE: 08/02/2023

NARRATIVE

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sleep logs missing from the youngest children.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22-05-CCP Page Four. CCC has completed testing and there were no exceedances. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

See LIC 809-D for one Type A and two Type B citations issued during today's visit.

The Licensee shall post a copy of this report and an Acknowledgement of Receipt of Licensing Reports (LIC 9224) to all parents of currently enrolled children, and children enrolled after 12 months of enrollment. The Licensee shall also maintain the signed forms in the children's files for the next 12 months from today's date.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Candace Martinez.
Report and Appeal Rights were provided.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/02/2023 02:42 PM - It Cannot Be Edited

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: 08/02/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

HSC

1596.871(c)(1)(A)

Administration of Child Day Care Licensing

Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision (f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in there was an adult with no fingerprint clearance caring for children which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 08/03/2023
	Plan of Correction
1 2 3 4	Director shall have the uncleared adult leave the premises and get clearance prior to working with children.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

Document Has Been Signed on 08/02/2023 02:42 PM - It Cannot Be Edited

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: 08/02/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101174(d)

Disaster and Mass Casualty Plan

(d) Disaster drills shall be conducted at least every six months. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in the last fire drill was conducted more than 6 months agowhich poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/01/2023
	Plan of Correction
1 2 3 4	Director shall conduct a fire drill and email the LPA a copy of an updated Fire Drill log.

Type B

Section Cited

CCR

101429(a)(2)(B)

Responsibility for Providing Care and Supervision for Infants

(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as staff were not logging the infants sleep every 15 minutes, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/01/2023
	Plan of Correction
1 2 3 4	The Director shall email the LPA 5 days of sleep log records.

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: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

LIC809 (FAS) - (06/04)

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