013420521-6-15-2022-02-CC-ASIH-CFEQFL-20220615120808

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013420521
Report Date: 06/15/2022
Date Signed: 06/15/2022 12:09:06 PM

Document Has Been Signed on 06/15/2022 12:09 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:	OAKLAND EARLY HEAD START - BROADWAY		FACILITY NUMBER:	013420521
ADMINISTRATOR:	SHERIFF, HAWA		FACILITY TYPE:	830
ADDRESS:	2619 BROADWAY		TELEPHONE:	(510) 238-7091
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94612
CAPACITY:	18	CENSUS: 5	DATE:	06/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Lynn Pham		TIME COMPLETED:	11:05 AM

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 06/15/2022 Licensing Program Analyst (LPA), Arminder Singh conducted an unannounced annual/random inspection at facility. LPA met with Acting Director, Lynn Pham and explained the purpose of today’s inspection. Hours of operation are Monday- Friday 8:30AM-4:30PM. The facility is located on the premises of First Presbyterian Church of Oakland. During today's visit there were 5 children present with 3 fully qualified teachers. Director was involved in cleaning/disinfecting toys and furniture when LPA arrived. LPA toured the Facility both inside and outside during today's inspection. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), and Activity Schedule. LPA reviewed three (3) children's files during today's inspection and two (2) staff files. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). Director has current mandated reporter training and current CPR and First Aid certifications on file. Facility understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). Facility conducts fire/earthquake drills at least once every six months. LPA observed the facility has posted food menu and activity schedules. Facility understands the conditions, limitations, and capacity specifications of the Facility license. Facility understands that children shall be visually supervised at all times. Continued on 809-C

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2022

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: OAKLAND EARLY HEAD START - BROADWAY	FACILITY NUMBER: 013420521
	VISIT DATE: 06/15/2022

NARRATIVE

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The Facility is aware of the required sign in and sign out procedures. Children are picked up by their respective parent(s)/guardian(s) and no child is allowed to go home on his/her own. Due to COVID-19 protocols parents drop off/pick up children at the front entrance where they are signed in/signed out. The facility conducts daily symptom screening as well.
LPA observed that the classroom is clean and safe for all children and staff. Drinking water is readily available for the children in the outdoor playground area via disposable cups. LPA observed solid waste containers with tight-fitting lids where food is served. Staff and children's bathrooms are clean, sanitary, and operable. Staff bathroom can be used as an isolation bathroom if needed. Facility does not have any weapons or firearms on the premises.

The facility provided breakfast, lunch and snack to all the children. Cleaning supplies are inaccessible to the children and stored in locked cabinets. Any poisons are stored in the locked storage cabinet.

LPA observed all furniture and equipment is in good condition and safe for the children.

Outdoor Space: Outdoor playground was inspected and observed to be fenced and safe . The play equipment was maintained in good condition and free of hazards. There were no bodies of water observed. The outdoor playground area has a shaded area for the children.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2022

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: OAKLAND EARLY HEAD START - BROADWAY	FACILITY NUMBER: 013420521
	VISIT DATE: 06/15/2022

NARRATIVE

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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.

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.

No deficiencies cited during today’s visit

Exit Interview was conducted, where this report was discussed with Director.

Report was signed confirming receipt of documents.

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

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2022

LIC809 (FAS) - (06/04)

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