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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417642
Report Date: 11/19/2019
Date Signed: 11/19/2019 02:26:25 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:SUNSHINE PRESCHOOL (CEID)FACILITY NUMBER:
013417642
ADMINISTRATOR:MCKENRICK, KYLAFACILITY TYPE:
850
ADDRESS:1035 GRAYSON ST, RM #8TELEPHONE:
(510) 848-4800
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY:45CENSUS: 11DATE:
11/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Jessica Salaam, Anna SchwarzbachTIME COMPLETED:
02:45 PM
NARRATIVE
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An unannounced Annual/Random site inspection was conducted by LPA Susan Neeson. Met with Jessica Salaam, Program Director and Anna Scwarzbach. Visit began at 12:30 PM. There are 11 children present and 4 teachers and 2 aids staff. Ratio was met throughout the visit. .

LPA did a health and safety inspection of the facility. The classroom was toured. The yard was toured. The bathroom has toilet paper, soap and paper towels to meet children's needs. There are adequate toys and equipment for children in care. The climbing structure is in good condition with poured rubber product under it to break falls. Fire Drills and Earthquake drills are being documented. Record keeping was discussed. Required forms were posted. Fire drills are being documented. First Aid kit is located in the classroom. There is a locked cabinet or refrigerator storage for prescription medications when needed. Children's records are being maintained. Roster is current. There are no bodies of water. Jessica Salaam states that there are no guns or firearms on the premises.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov and for day care updates visit www.myccl.gov
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
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: SUNSHINE PRESCHOOL (CEID)
FACILITY NUMBER: 013417642
VISIT DATE: 11/19/2019
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This facility does not plan 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. There are no children who need IMS currently enrolled.

There were the following forms and information issued: Applicants rights, Safe Sleep for infants, safe diapering, fire/earthquake information, car seat information, blue immunization forms, Departmental update, LIC 9040 blank form and LIve Scan forms.

Received LIC 500 during visit.

No deficiencies are observed.



An exit interview was given.
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2