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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013415316
Report Date: 01/11/2024
Date Signed: 01/11/2024 11:11:57 AM


Document Has Been Signed on 01/11/2024 11:11 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:EXTENDED DAY CHILD CARE CENTER, INC. - DOUGHERTYFACILITY NUMBER:
013415316
ADMINISTRATOR:REQUIRO-CASABAR, NOREENFACILITY TYPE:
840
ADDRESS:5301 HIBERNIA DRIVETELEPHONE:
(925) 803-4154
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:120CENSUS: 0DATE:
01/11/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Director, Noreen Requiro- CasabarTIME COMPLETED:
11:25 AM
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Licensing Program Analyst (LPA) Jyoti Saini met with Director Noreen Casabar-Requiro for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the director. There were no children present during the inspection. The program consists of two sessions: 7:00 am to 9:00 am and 12:00 pm to 6:00 pm Monday - Friday in room EDCC #1(AKA Dolphin ages K-1st grade) and room # EDCC 2 ( AKA stingray ages 2nd grade to 5th grade) on the DOUGHERTY ELEMENTARY SCHOOL CAMPUS. The facility was inspected indoors and outdoors today for health and safety hazards, and the following was observed:
There are no bodies of water, firearms, or weapons on the premises. The Center is in good condition with proper temperature and ventilation, and is free of any hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. The children and staff have a separate bathroom. The bathrooms appear safe, sanitary, and free of any hazardous items. Drinking water is readily available through water fountains and water bottles brought from home. A menu is posted for the entire month. The facility only provides snacks, and the school district provides lunch. The classroom has appropriate postings. The last Emergency Drill was conducted on 01/12/2023 at 1:43 pm and is properly logged. The outdoor play area was free of hazards and provided a shaded area for the children. Medications are stored on a high shelf, inaccessible to children in care.
LPA reviewed the sign-in and out sheet. The facility uses the Kangaroo Times (KT) app to sign the children in and out. There are multiple first aid kits available. There is a working fire alarm system at the elementary. Both the rooms have an active smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available. All children have a record of emergency identification information. The staff records reviewed were complete. All staff members have a criminal record clearance on file. The site Director and staff have a current Pediatric First Aid/CPR certificate. All staff have taken Mandated Reporter training. The center roster was reviewed, and a copy was obtained.

see next page..
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:
DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/11/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: EXTENDED DAY CHILD CARE CENTER, INC. - DOUGHERTY
FACILITY NUMBER: 013415316
VISIT DATE: 01/11/2024
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Criminal Record Clearance -

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Lead Testing –


CCC COMPLETED TESTING
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
Incidental Medical Services (IMS)
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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

MyChildCarePlan.org
The director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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 deficiency is 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 director, Noreen Casabar-Requiro.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
LIC809 (FAS) - (06/04)
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