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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417786
Report Date: 06/17/2020
Date Signed: 07/01/2020 01:14:36 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:ST. JOACHIM PRESCHOOLFACILITY NUMBER:
013417786
ADMINISTRATOR:MELGAREJO, MARISSAFACILITY TYPE:
850
ADDRESS:21250 HESPERIAN BLVD.TELEPHONE:
(510) 783-0604
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY:45CENSUS: 0DATE:
06/17/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
03:36 PM
MET WITH:Marisa MelgarejoTIME 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
DUE TO THE COVID-19 SHELTER IN PLACE ORDER BY THE GOVERNOR OF CALIFORNIA, THIS CASE MANAGEMENT INSPECTION WAS DONE VIA TELE-VISIT THROUGH FACETIME.

A Case Management Visit was conducted on this date 6/17/2020 by Licensing Program Analyst (LPA), Melanie Otsuji. LPA conducted the tele-visit with Director Marisa Melgarejo. The center has submitted an application for an increase in capacity from 45 to 60 children. The center has added a bathroom in Room #3. The bathroom has 1 sink and 2 toilets. The center will be operating in 3 classrooms (Rooms 1, 2, & 3). Hours of operation are from 7:45AM - 3:30PM, Monday through Friday. A health and safety inspection was conducted inside and outside. The following is the total overall measurement:



INDOORS: 2329.678 square feet = 67 children
OUTDOORS: 2935.6 square feet = 39 children

There are 4 sinks and 5 toilets available for children. There is a separate staff bathroom on the premises. Playground equipment is in good condition. Drinking water is available inside and outside. A yard waiver is being requested to allow no more than 39 children at a time on the play yard. All toilets and hand washing facilities are in safe and sanitary operating conditions. Snacks are provided and prepared on site. Snack menus are posted. Children bring lunch from home with the option of hot lunch to be provided by a third party. There is adequate variety and quantity of foods to meet the children's needs. The storage of napping equipment was observed. Facility has a functioning carbon monoxide detector.

The center has obtained an approved fire safety inspection from the Hayward Fire Department on 3/27/2020. All licensing required documents are posted.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2020
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: ST. JOACHIM PRESCHOOL
FACILITY NUMBER: 013417786
VISIT DATE: 06/17/2020
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
Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. Director is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, 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.

Zero Tolerance policies were explained. Notice of Site Visit form was provided and posted.
The center was found to be clean, safe, sanitary and in good repair. There are no deficiencies cited during this visit. A license for 60 preschool children will be issued effective today 6/17/2020.

An exit interview was conducted. Appeal rights provided.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2