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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010213755
Report Date: 11/22/2019
Date Signed: 11/22/2019 12:52:28 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:WEE CARE PRESCHOOL AND CHILD CAREFACILITY NUMBER:
010213755
ADMINISTRATOR:WILSON, EMERALDFACILITY TYPE:
830
ADDRESS:2133 CENTRAL AVENUETELEPHONE:
(510) 523-7858
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:24CENSUS: 11DATE:
11/22/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Emerald WilsonTIME COMPLETED:
12:55 PM
NARRATIVE
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LPA Dayna Collier met with Center Director Emerald Wilson for a case management inspection as a result of receiving an unusual incident report. Today, there were 2 staff members supervising 11 infants (8 of which were napping). An incident occurred when a staff member was changing an infant on the changing table in the classroom. As the staff member reached to retrieve something, the infant rolled off of the table and landed on the floor. The infant was assessed for injury and the parent was contacted. The parent sought a medical assessment for the infant. Per director, the staff member did not use the strap on the changing pad to belt the child down. During the inspection today, the director was provided a copy of the proposed Safe Sleep Regulations and Best Practices.

The attached type B deficiency is cited today and must be corrected by the due date. This report must be available for public review for 3 years.
An exit interview was conducted and the report was discussed. Licensee was provided a copy of their appeal rights (LIC 9058 12/15) and the signature on this form acknowledges receipt of these rights.

A site visit notice was posted by Director.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019
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: WEE CARE PRESCHOOL AND CHILD CARE
FACILITY NUMBER: 010213755
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/22/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/06/2019
Section Cited

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101429 Responsibility for Providing Care and Supervision for Infants
(a) In addition to Section 101229, the following shall apply:
(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. Under no circumstances shall ANY infant be left unattended.
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This requirement was not met as evidenced by report review and interviews. This poses a potential risk to infants in care.
WHILE A STAFF MEMBER WAS REACHING FOR SOMETHING, AN INFANT FELL OFF OF THE CHANGING TABLE.
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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: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:
DATE: 11/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/22/2019
LIC809 (FAS) - (06/04)
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