<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010215763
Report Date: 09/06/2024
Date Signed: 09/06/2024 11:18:45 AM


Document Has Been Signed on 09/06/2024 11:18 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:HOLY SPIRIT PRESCHOOLFACILITY NUMBER:
010215763
ADMINISTRATOR:TARRANT, CECILIAFACILITY TYPE:
850
ADDRESS:3930 PARISH AVENUETELEPHONE:
(510) 793-2013
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:36CENSUS: 23DATE:
09/06/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Elizabeth CummingsTIME COMPLETED:
11:30 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
On September 6, 2024 at approximately 8:20am, Licensing Program Analyst (LPA) Randy Miranda arrived unannounced for an annual inspection for compliance to Health and Safety. Present for the inspection was Assistant Director Elizabeth Cummings, three fingerprint and associated teachers and 23 children in care ages 3 to 5. Hours of Operation are Monday – Friday 7am to 5pm. The center is in ratio today.

The childcare center operates on the campus of the Holy Spirit church and school grounds in two large separate preschool classrooms (Caterpillar and Butterfly). The children have their own playground, all structures are in safe condition and free from sharp, loose or pointed parts. Areas around or under high climbing equipment has appropriate cushioned material that absorbs a fall. Children bring their own bottled water from home and the school also provides access to filtered drinking water pitchers.



All documents required to be posted were appropriately posted on the walls: License; Emergency Disaster Plan; Earthquake Preparedness checklist; Notification of Parents Rights; Personal rights; Child seatbelt laws; menus; daily activity schedules.

The facility is clean and well organized with ample age-appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. Hazardous items/toxins are kept in a cabinet in the staff restroom out of the access of children. There are no bodies of water accessible to children in care. Children bring their own food from home; the center provides snacks. Snack food was checked and all items not expired.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Randy MirandaTELEPHONE: (510) 359-0974
LICENSING EVALUATOR SIGNATURE:
DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/06/2024
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 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HOLY SPIRIT PRESCHOOL
FACILITY NUMBER: 010215763
VISIT DATE: 09/06/2024
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
The facility has fully charged 3A40BC fire extinguishers available throughout the building mounted next to each classroom door. A fire extinguisher is also located in the Director’s office, next to the front door. The last fire alarm inspection was conducted by Trojan Systems on 8/26/2024. Fremont Fire Department conducts fire inspections, the last inspection was completed 8/21/2024, all systems passed. Carbon monoxide detectors were tested and functioning. Heating and ventilation in the classrooms are acceptable.

Children use their own bathroom located in the Caterpillar classroom. There are enough towels and soap supplies. The staff have separate adult bathrooms.

Disaster drills are conducted monthly, the last drill was conducted on 7/19/2024.



The electronic sign in/out sheets (Brightwheel) were reviewed and are accurate. Classrooms have trash cans with tight fitting cover for the disposal of solid waste. Two children currently require IMS (inhalers) and two children require epi pens. Medications are held at the school, were all checked and none were expired.

Children's records were reviewed, a copy of the facility roster was taken by the LPA. All files selected were complete and up to date.

Staff files were reviewed: Opening and closing staff have current CPR and first aid training. All staff subjected to criminal review have been cleared and associated to the facility. All records were complete and very organized.

Assistant Director 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 Childcare 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Randy MirandaTELEPHONE: (510) 359-0974
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HOLY SPIRIT PRESCHOOL
FACILITY NUMBER: 010215763
VISIT DATE: 09/06/2024
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
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

No deficiencies were cited today.



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

Exit interview conducted and report was reviewed with Assistant Director Elizabeth Cummings.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Randy MirandaTELEPHONE: (510) 359-0974
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3