010215033-9-22-2020-02-CC-MMEA-BTPS6L-20200922133604

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010215033
Report Date: 09/21/2020
Date Signed: 09/22/2020 01:36:11 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:	OAKLAND HEAD START - MANZANITA		FACILITY NUMBER:	010215033
ADMINISTRATOR:	LINDA FRAZIER-MOORE		FACILITY TYPE:	850
ADDRESS:	2701 - 22ND AVENUE		TELEPHONE:	(510) 535-5627
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94606
CAPACITY:	20	CENSUS:	DATE:	09/21/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Terry Chen		TIME COMPLETED:	11:00 AM

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 Manager (LPM) Mayla Mendoza met today 9/21/20 with Director Terry Chen for a CASE MANAGEMENT inspection. Facility is requesting to return to active status. LPM conducted a tele-visit inspection of the facility and play yard for a health and safety inspection. The classroom(s) and play yard were age appropriate and in good repair. Previous kitchen was converted partially into a bathroom with 2 toilets and 2 sinks. Bathrooms were clean. There is a separate staff bathroom. Breakfast, lunch and snacks are delivered and prepared on site. The kitchen area was maintained in a clean manner and was inaccessible to children in care. Waste containers have tight fitting lids. The storage of napping equipment was observed. Cots will be used. The sign in and out logs were reviewed. Firearms and other weapons are not being stored on the premises. All posting requirements are being met. Outdoor play area was free of hazards and provided a shaded area for the children and access to drinking water. Play ground equipment is cushioned with material that absorbs a fall (turf). There are no bodies of water. The facility has a charged fire extinguishers and first aid kits. Fire and disaster drills will be conducted monthly. There is a working telephone at the facility. At least one person trained in CPR and Pediatric First Aid is present. Medications, when dispensed, are inaccessible to children and follow the IMS Plan of Operation. This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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 - MANZANITA	FACILITY NUMBER: 010215033
	VISIT DATE: 09/21/2020

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
26
27
28
29
30
31
32

A REVIEW OF STAFF RECORDS ON 9/21/20 INDICATES THAT ALL FACILITY STAFF OR OTHER INDIVIDUALS WHO REQUIRED CAREGIVER BACKGROUND CHECKS HAVE RECEIVED CRIMINAL RECORD AND CHILD ABUSE INDEX CLEARANCES OR EXEMPTIONS.

COVID-19 safety protocols, mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements was discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, PINs (Provider Information Notices), and the director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

As a result of this inspection, there are no deficiencies cited during today's inspection.

Before facility can re-open, the following is needed:

*carbon monoxide detector

An exit interview was conducted and a site visit notice was posted.

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2