010212475-8-11-2023-02-CC-ILOA-CULQLR-20230811121622

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010212475
Report Date: 08/11/2023
Date Signed: 08/11/2023 12:16:37 PM

Document Has Been Signed on 08/11/2023 12:16 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:	OAKLAND HEAD START - SAN ANTONIO		FACILITY NUMBER:	010212475
ADMINISTRATOR:	JIMINEZ, LOURDES		FACILITY TYPE:	850
ADDRESS:	2228 EAST 15TH STREET		TELEPHONE:	(510) 535-5639
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94606
CAPACITY:	24	CENSUS: 0	DATE:	08/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:57 AM
MET WITH:	Lourdes Jiminez		TIME COMPLETED:	12:24 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 11, 2023 at 8:57am Licensing Program Analyst (LPA) Indira Loza met with Center Director Lourdes Jiminez to conduct the an unannounced 1-year required annual inspection. There were no children in care as the center is on summer break until August 15, 2023. The operation hours are Monday - Friday 8:30am-4:30pm. The preschool operates out of one room with three toilets and two sinks. All sinks and toilets are observed to be clean and in proper working order. The facility has age appropriate materials in the classroom that are observed to be clean and in good condition. All toxins, cleaning products, and hazardous materials were in inaccessible areas. The children are provided with water via filled jugs and disposable cups. The fire system is hard wired. The outdoor play area is clean with ample age appropriate materials for the children. The yards are fully fenced in and has plenty of shade for the children. LPA did not observe any harmful or unattended bodies of water in or around the facility. The isolation area will be in the Director's office. The facility has a working carbon monoxide detector, smoke detector, and a 3A40BC fire extinguisher. All proper postings are made visible. The school provides breakfast, lunch, and one snack to the children. All staff have obtained a criminal record clearance. LPA reviewed all of the current staff records and a sample of 6 children's files. All files were complete and current. Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) *******************************************Report continues on 809-C********************************************

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023

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: OAKLAND HEAD START - SAN ANTONIO	FACILITY NUMBER: 010212475
	VISIT DATE: 08/11/2023

NARRATIVE

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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.

The facility provides IMS services but doesn't have any at the facility as they were returned to the parents before summer break. The facility has all the required documentation but will have the parents bring the medication upon returning from summer break. 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.

There were no deficiencies cited during today's visit.

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

Exit interview conducted and report was reviewed with Director Lourdes Jiminiz.
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: 08/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023

LIC809 (FAS) - (06/04)

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