013417786-7-22-2021-52-CC-EWOS-C56USC-20210722155008

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013417786
Report Date: 07/22/2021
Date Signed: 07/22/2021 03:50:16 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 PRESCHOOL		FACILITY NUMBER:	013417786
ADMINISTRATOR:	MELGAREJO, MARISSA		FACILITY TYPE:	850
ADDRESS:	21250 HESPERIAN BLVD.		TELEPHONE:	(510) 783-0604
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	60	CENSUS: 13	DATE:	07/22/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Marisa Melgarejo		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	Licensing Program Analyst (LPA) Elimika Woods arrived to the facility at 1:40 PM to conduct an Annual Required Inspection and met with Director, Marisa Melgarejo. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Director. There were thirteen (13) preschool age children and three additional staff members present during this inspection. The facility and playground were toured for a health and safety inspection. The preschool consists of 3 classrooms located in the left rear of St. Joachim Church. Hours of operation are Monday through Friday, 7:45 AM to 3:30 PM CLASSROOMS: At 2:00 PM, LPA Woods toured the three (3) classrooms used for child care. There are adequate play and learning materials available. There is adequate heating/air conditioning, ventilation and lighting. The floors, furniture, and equipment are age appropriate and in good repair. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is in the director's office. There are three (3) fully charged 3A40BC fire extinguishers, a functioning carbon monoxide detector, smoke and sprinkler system, first aid supplies, and pull down fire alarm throughout the classrooms. All solid waste storage containers have tight fitting covers on, and appear to be in good repair. BATHROOMS AND TOILETING AREAS: There are separate bathrooms for staff and children. Toilets and faucets are in safe and sanitary operating condition. The children are able to reach the sinks and toilets. Supplies are available to the children. See 809-C.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: ST. JOACHIM PRESCHOOL	FACILITY NUMBER: 013417786
	VISIT DATE: 07/22/2021

NARRATIVE

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FOOD SERVICE AREAS: The menus are posted at least one week in advance, available for review by parents and dated. The children also bring their snacks to eat from home.

OUTDOOR PLAY AREAS: There are no bodies of water, or free standing water accessible to children. There are age appropriate toys and materials for the children. There’s an umbrella used to provide the children with shade on the playground. The playground is fenced and all equipment and surfaces are safe and free from hazards. The climbing structure is anchored with cushioning materials to absorb falls.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Three (3) Children's files and three (3) staff files were reviewed around 2:35 PM. All files have required health screening, immunization, employee rights, and mandated reporter training. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed and certificates were reviewed. Director's CPR and First Aid certificate is current and expires on 06/05/23. The center is in compliance with the sign in and out procedure.

Disaster drills are being conducted at least once every 6 months and the log indicates the last one conducted was on 06/30/21. Per director, there are no firearms stored on the premises. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: No IMS is being provided at this time and no medication is being stored. The center is equipped with a fully stocked first aid kit that are available in the classroom.

See 809-C.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: ST. JOACHIM PRESCHOOL	FACILITY NUMBER: 013417786
	VISIT DATE: 07/22/2021

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California Law requires Family Child Cares/Child Care Centers licensees 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 electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

Director is reminded that ALL assistants, volunteers, and staff, 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. Director was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

Incident Medical Services (IMS) policy was discussed. Per licensee, no IMS is being provided at this time. The licensee was reminded that when any changes to the IMS plan is made, an updated 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.” Licensee was reminded to visit our website at www.ccld.ca.gov to get quarterly updates on new laws and regulations.

No deficiency cited during today’s visit. A Notice of Site visit was posted at time of inspection and must remain posted for 30 days. Exit interview conducted with the Director. A copy of the report was provided

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

LIC809 (FAS) - (06/04)

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