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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418175
Report Date: 03/20/2023
Date Signed: 03/20/2023 04:14:03 PM


Document Has Been Signed on 03/20/2023 04:14 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:FUZZY CATERPILLARFACILITY NUMBER:
013418175
ADMINISTRATOR:RISSE, TALIFACILITY TYPE:
850
ADDRESS:1510-1504A ENCINAL AVENUETELEPHONE:
(510) 205-0985
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:66CENSUS: 62DATE:
03/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Tali RisseTIME COMPLETED:
04:25 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
On 3/20/2023 at 11:45am, Licensing Program Analyst (LPA) Catherine Fernandes met with Director Tali Risse for an Unannounced Required Annual Inspection. There were 62 preschool age children in care and eight finger print cleared additional staff members. The teacher- child ratio was being met today. The center was toured for a health and safety inspection. The facility operates from Monday through Friday from 7:00am–6:00pm.

The center operates at two addresses, right next door to each other. 1510 is a converted house with four main areas for the children and 1504- A is a rented space with one main classroom. The room floors, surfaces, furniture and equipment appear to be safe, sanitary and in good repair. The heating, lighting and ventilation is adequate. There is a total of six toilets, and eight sinks available for the children which are sanitary and in operational conditions. There are supplies available for the children to wash and dry their hands. There are bathrooms for staff. The activities and toys appear to be age appropriate for the children in care. The outside play area is fully fenced with shaded areas for the children. There is a climbing structure that is sturdy and anchored into the ground, there are wood chips for cushioning to absorb the impact from a fall. LPA did not observe any bodies of water, free standing water, cleaning supplies, or toxic items accessible to children during today’s inspection. The center prepares and provides snacks to the children and lunches are brought from home. The kitchen area was maintained in a clean manner. There is a current snack menu posted. The center has completed their leading testing and will drink water from the main campus. All the children have personal water bottles and teachers bring a pitcher of water outside while outdoors. The children have their own cubbies and hooks to store personal belongings. The fire system is a push button, with multiple carbon monoxide/smoke detectors throughout the center and a fully charged fire extinguisher.



All proper postings are made visible by the front of the center’s entrance. The fire/disaster drill log was complete with the last drill logged 2/15/2023. The sign-in and out log was reviewed. All children were accounted for and properly signed in. LPA reviewed 10 children’s files and seven staff files. LPA obtained a copy of the children’s roster and an updated Personnel report.
Report continued on 809C
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2023
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 3


Document Has Been Signed on 03/20/2023 04:14 PM - It Cannot Be Edited

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: FUZZY CATERPILLAR

FACILITY NUMBER: 013418175

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 03/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(3)(B)
Health-Related Services
(3) Prescription medications may be administered if all of the following conditions are met: (B) For each prescription medication, the licensee shall obtain, in writing, approval and instructions from the child's authorized representative for the administration of the medication to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in three out of the four children had incomplete conditions which poses a potential health risk to persons in care.
POC Due Date: 04/03/2023
Plan of Correction
1
2
3
4
Center will review the regulations regarding medication, and conduct an inventory of all medications to reflect what is being done at the center. Then send a statement of completion with a plan to ensure all regulations are being followed to CCL by proof of correction date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3


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: FUZZY CATERPILLAR
FACILITY NUMBER: 013418175
VISIT DATE: 03/20/2023
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
At 2:15pm, while reviewing the center's medications (incidental medical service) three out of four children had incomplete forms.

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities 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 email. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

This facility provides Incidental Medical Services, For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

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.

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

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

See 809D for the deficiency cited.

Exit interview conducted and reviewed with the Director Risse


Report and Appeal Rights provided
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3