010216245-7-6-2022-02-CC-ILOA-CG3UMR-20220706154247

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010216245
Report Date: 07/06/2022
Date Signed: 07/06/2022 03:44:10 PM

Document Has Been Signed on 07/06/2022 03:44 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:	UCB - CLARK KERR CAMPUS CHILDREN'S CENTER		FACILITY NUMBER:	010216245
ADMINISTRATOR:	DARRELL WHITACRE		FACILITY TYPE:	850
ADDRESS:	2900 DWIGHT WAY, BLDG. #5		TELEPHONE:	(510) 643-5527
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94720
CAPACITY:	17	CENSUS: 11	DATE:	07/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:05 PM
MET WITH:	Pratibha Chaya		TIME COMPLETED:	04:00 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 July 7, 2022 at 12:05 pm Licensing Program Analyst (LPA) Indira Loza and Licensing Program Manager (LPM) Mayla Mendoza arrived at the facility and met with Site Supervisor Pratibha Chhaya and Center Director Boris Alvarado for the purpose of an UNANNOUNCED ANNUAL RANDOM INSPECTION. Present for this inspection were 4 fully qualified teachers and 11 preschoolers. The facility was toured to conduct a Health and Safety Inspection. There are ample age appropriate toys that appear to be safe and in good condition. There are no bodies of water accessible to children in care. The furniture and equipment is in safe condition and is free from sharp, loose or pointed parts. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible today. All toilets, hand washing and cleaning areas are in safe and sanitary operating condition. All surfaces accessible to children are clean and toxic free. The last fire drill was conducted June 23, 2022. There is a 3A1040BC fire extinguisher on site. The sign in/out binder was reviewed and the children are signed in. Meals are provided by the Child and Adult Care Program and is delivered daily. Menu is posted and visible for review. The playground equipment is in safe condition and free from sharp, loose or pointed parts and the areas around or under high climbing equipment has appropriate cushioned material that absorbs a fall. Drinking water is provided both indoors and outdoors. All staff subjected to criminal review have been cleared and associated to the facility. LPA requested the staff and children files. LPA reviewed children's and staff files which were found in compliance. CPR and First Aid is current for staff on site. Currently, no children are on medication. A child care roster and a personnel roster was obtained. The facility is operating within its licensed capacity. LPA verified both opening and closing staff have current CPR/First aid training. ********************************************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: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

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: UCB - CLARK KERR CAMPUS CHILDREN'S CENTER	FACILITY NUMBER: 010216245
	VISIT DATE: 07/06/2022

NARRATIVE

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Director was reminded that California Law requires Director 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 form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting http://www.mandatedreporterca.com.

Children’s Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months
and documented. The Licensee is reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02 CCP. When any IMS is provided, a Plan for Providing 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.

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/process.
Director was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home or 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 withthe Director and discussed the Child Care Licensing Safe Sleep webpage at
********************************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: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: UCB - CLARK KERR CAMPUS CHILDREN'S CENTER	FACILITY NUMBER: 010216245
	VISIT DATE: 07/06/2022

NARRATIVE

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https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on
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.

There were no deficiencies cited during todays visit. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Boris Alvarado .

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

LIC809 (FAS) - (06/04)

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