013417823-3-15-2023-02-CC-ILOA-CPXUHV-20230315153634

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013417823
Report Date: 03/15/2023
Date Signed: 03/15/2023 03:36:43 PM

Document Has Been Signed on 03/15/2023 03:36 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	BERKELEY YMCA HEAD START - WEST YMCA		FACILITY NUMBER:	013417823
ADMINISTRATOR:	CARLOTA HERNANDEZ DE CRUZ		FACILITY TYPE:	830
ADDRESS:	2009 TENTH STREET		TELEPHONE:	(510) 848-9092
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94710
CAPACITY:	16	CENSUS: 10	DATE:	03/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:32 AM
MET WITH:	Carlota Hernandez De Cruz		TIME COMPLETED:	03:39 PM

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On March 15, 2023, at 11:32AM, Licensing Program Analyst (LPA) Indira Loza met with Director Carlota Hernandez De Cruz for an unannounced required annual inspection. The infant center was inspected to conduct a health and safety check. Present during the inspection were 10 infants and six additional finger print cleared staff members. The teacher/child ratio was being met today. This center operates from 7:30am - 5pm Monday through Friday.

The infant component operates out of one large classroom. As of today no infants require cribs. The furniture, equipment and activities appear to be age appropriate for the children in care. The heating and lighting is adequate. The center provides cups and drinking water for the children. There are two changing tables in the classroom and both changing table are within arms reach of the sink. LPA observed all cleaning supplies or toxic items inaccessible to children. Lunches and snacks are provided by the center. There are menus posted in the kitchen, classroom, and in the hallway. The outside play area is adjacent to the preschool play yard and is divided by a fence. LPA observed a shaded area and age appropriate toys, that appear to be in good condition. All required documents are posted for public review. Disaster drills are being conducted at least once every 6 months, the last drill was recorded on January 27, 2023. The center is equipped with a fully stocked first aid kit, and a working phone. LPA observed a fully charged 2A10BC fire extinguisher. The fire system is hard wired. There is a working combined smoke and carbon monoxide detector on the wall across from the kitchen. LPA reviewed 5 staff files and 10 children files, which were all complete. IMS is being provided.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov. For additional

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SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BERKELEY YMCA HEAD START - WEST YMCA	FACILITY NUMBER: 013417823
	VISIT DATE: 03/15/2023

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information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

There were no deficiencies cited during today's visit.

A notice of site visit was given and must remain posted for 30 days

Exit interview conducted and report was reviewed with the Director Carlota Hernandez De Cruz.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

LIC809 (FAS) - (06/04)

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