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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417786
Report Date: 07/20/2023
Date Signed: 07/20/2023 02:12:56 PM


Document Has Been Signed on 07/20/2023 02:12 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
OAKLAND SOUTH EAST, 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:60CENSUS: 15DATE:
07/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Marissa MelgarejoTIME COMPLETED:
02:30 PM
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On July 20, 2023 at 11:50 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced Annual Required Inspection and met with the facility representative, Marissa Melgarejo. LPA disclosed the purpose of the inspection and was granted entry into the facility by the facility representative. There were 15 children present during this inspection and three (3) additional staff members. The facility consists of three (3) classrooms. The facility and playground was toured inside and out for a health and safety inspection. The hours of operation are 7:45 AM to 3:30 PM, Monday -Friday

LPA checked the facility RECORDS and they show all individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. LPA conducted a census of the children and the census matches the children signed in on the electronic system. LPA reviewed three (3) children's files and one (1) staff file around 1:00 PM. All staff files have required Health Screening, and Employee Rights, and all children files contains Personal Rights, Medical Consent forms, and Identification & Emergency Information. 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 03/2025.


The three (3) classrooms were inspected around 12:00 PM and teacher-child ratio was observed. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. 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 the director's office, away from other children in care. The center has a wired smoke and carbon monoxide detectors, sprinkler system, working telephone, pull down fire alarm system, and three (3) fully charged 3A40BC fire extinguishers which meets standards established by the State Fire Marshal. Disaster drills are being conducted at least once every 6 months and the last one conducted was on 05/26/23. All required documents are posted in a public accessible area.



See 809-C.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:
DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/20/2023
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: ST. JOACHIM PRESCHOOL
FACILITY NUMBER: 013417786
VISIT DATE: 07/20/2023
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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-carecenters/.

LPA reminded the facility representative that a refrigerator shall be used to store any medications that requires refrigeration. The center is equipped with fully stocked first aid kits that are available in the classrooms.

The children bring their lunch and snacks to eat from home. There are weekly menus posted at the facility. LPA observed an area where they have a refrigerator this area is clean and free of evidence of rodents. Food is protected from contamination and, per staff, contaminated food is discarded immediately. All storage containers for solid waste have tight fitting covers that are in good repair.

The outdoor area has a play structure with a slide that has cushioning to absorb children falls. There's multiple canopies that provide shade to children while at play. The facility representative also stated that the staff brings the children’s water bottles and cups to keep the children hydrated. The play equipment is age appropriate and in good repair.



The staff's bathroom is separate from the children's bathroom and all sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets and the paper towels and soap are available to the children.

California Law requires 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.

Lead Testing – Child Care Centers (CCC) CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: 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. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

See 809-C

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
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: ST. JOACHIM PRESCHOOL
FACILITY NUMBER: 013417786
VISIT DATE: 07/20/2023
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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.

The 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.

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

There are no deficiencies 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 facility representative, Marissa Melgarejo.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC809 (FAS) - (06/04)
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