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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419485
Report Date: 03/23/2022
Date Signed: 03/23/2022 06:20:05 PM


Document Has Been Signed on 03/23/2022 06:20 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:TUDORKA TOTS INFANT AND PRESCHOOL CENTERFACILITY NUMBER:
013419485
ADMINISTRATOR:ZIMANY, RENATAFACILITY TYPE:
830
ADDRESS:12000 CAMPUS DRIVETELEPHONE:
(510) 531-2223
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY:28CENSUS: 15DATE:
03/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:24 AM
MET WITH:ZIMANY, RENATATIME COMPLETED:
06:20 PM
NARRATIVE
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 On 3/23/22 at 10:24AM, Licensing Program Analysts (LPAs) Indira Loza and Catherine Fernandes arrived to conduct a required annual inspection. LPAs met with Director/Owner Renata Zimany. LPAs observed 5 staff members and 15 infants in care.

LPAs inspected the infant center and conducted a file review of all staff and 10 children's files.

During the inspection and file review LPAs observed one staff member, Martha Avalos caring for infants while at the center without having cleared finger prints. Director/ Owner confirmed that the staff member has been at the center for fours years. LPAs observed Martha Avalos prints as pending in guardian.

LPA Fernandes observed an infant crying in the nap room while on their stomach with a pacifier getting put down for a nap. Director stated that the infant is sleep training and that this is how the infants mother wanted the infant to be put down for their nap.

Two type A deficiency were cited during todays inspection. The Director must provide a copy of this report to all parents of children currently enrolled, and the parents of newly enrolled children in the next 12 months. In addition, form LIC 9224 (Acknowledgment of Receipt of Licensing Reports) must be signed by each parent and placed in each child's file.

A copy of the LIC 9224 and AB 633 fact sheet were provided to the Licensee during the inspection.
An immediate Civil penalty is being assessed in the amount of $500. See form LIC 421BG.

Exit interview conducted with Director Zimany
Report and Appeal Rights provided
Notice of site visit provided
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2022
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


Document Has Been Signed on 03/23/2022 06:20 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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/23/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101430(3)(A)

Infant Care Activies: Staff shall place infants up to 12 month of age on their backs for sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations there was an infant laying in the crib, on their stomach with a pacifier in their mouth the licensee did not comply with the section cited above, which poses an immediate health, safety risk to persons in care.
POC Due Date: 03/24/2022
Plan of Correction
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Director is to meet with the parents and fill out the infant safe sleep plan and review the regulations on Infant Care Activities. Then write a statement of what was learned and send a copy of the sleep plan for the child to CCL by 3/24/22
Type A
Section Cited
CCR
101170(e)
Criminal Record Statement: All individuals subject to a criminal record review prior to working in a licensed facility prior to working in a licensed facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interviews and conformation from the Director Zimany, staff member Martha Avalos has a pending fingerprints and is not cleared to work at the day care, the center did not comply with the section cited above, which poses an immediate safety risk to persons in care.
POC Due Date: 03/24/2022
Plan of Correction
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Center is to remove the staff person immediately.
*While at the center the staff member was sent home, Director stated she went to get fingerprinted.
An immediate civil penalty of $500 is being assessed.

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) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2