010212689-11-9-2021-52-CC-MOTI-C8LRMQ-20211109120906

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010212689
Report Date: 11/09/2021
Date Signed: 11/09/2021 12:09:18 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	YMCA OF THE EAST BAY Y-KIDS JAMES LEITH		FACILITY NUMBER:	010212689
ADMINISTRATOR:	MCKINNON, ERICKA		FACILITY TYPE:	840
ADDRESS:	47100 FERNALD STREET		TELEPHONE:	(510) 683-9147
CITY:	FREMONT	STATE: CA	ZIP CODE:	94539
CAPACITY:	48	CENSUS: 3	DATE:	11/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Jennifer Lee		TIME COMPLETED:	12:20 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	Licensing Program Analyst (LPA) Melanie Otsuji arrived to the facility unannounced to conduct a Required 1 Year inspection. LPA met with Head Teacher, Jennifer Lee. The center operates out of a portable located on the back side of Fremont Unified School Districts James Leith Elementary School. Present for this inspection was 2 finger print cleared and associated staff, and 3 school aged children. LPA Otsuji conducted a health and safety inspection of the facility at 10:15AM. Disinfectants and cleaning solution were observed to be kept in areas which are inaccessible to children in care during today's inspection. Classroom, furniture, and outside play equipment are in safe condition. The toilets, and hand washing facilities are in safe and sanitary operating condition. The program utilizes the Elementary School bathrooms. The children have access to drinking water both indoors and outdoors. The center utilizes the schools playground for outdoor play. Each staff member who currently works at this facility has the proper criminal record clearance. There is a staff member present with current CPR/First aid whenever children are present. LPA reviewed the 2 staff files who are currently employed at this facility. Each staff file contained documentation on their provider immunization's. LPA reviewed 3 children's files. Fire/Earthquake Drill was last conducted on 10/8/2021. The center is equipped with a first aid Kit, working telephone, 2A10BC fire extinguisher, and smoke detectors. This facility provides Incidental Medical Services (IMS). LPA reviewed the storage of medication and equipment and supplies, and reviewed children’s, personnel, and administrative records. LPA discussed the need to update the centers plan of operation to reflect IMS plan. Specifics on the plan can be found in the child care center evaluator manual (CCC EM) Policy 101173. The following information regarding ADA was provided to Director. US DOJ toll free ADA Information Line (800) 514-0301 and the link to FAQ about child care and ADA http://www.ada.gov/childqanda.htm See 809C for continuation page...

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: YMCA OF THE EAST BAY Y-KIDS JAMES LEITH	FACILITY NUMBER: 010212689
	VISIT DATE: 11/09/2021

NARRATIVE

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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.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep web page 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. Facility representative was reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care.

Facility representative was reminded of the responsibility as a mandated reporter and the training's must be done once every two years as well as CPR/First Aid needs to be renewed every two years and must be EMSA approved. LPA also encouraged facility representative to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded. For licensing updates and Quarterly Child Care Distribution email, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Effective August 1, 2003 California Law requires Child Care 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 for (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624 within 7 business days.

LPA is requesting facility representative email a current LIC 500 (Personnel Roster) and LIC 9040 (Children's Roster) to be submitted to LPA no later than 11/30/2021.

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, Jennifer Lee.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

LIC809 (FAS) - (06/04)

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