013420552-2-16-2023-02-CC-ACUY-CP4SQ7-20230216130416

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013420552
Report Date: 02/16/2023
Date Signed: 02/16/2023 01:04:29 PM

Document Has Been Signed on 02/16/2023 01:04 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:	OUSD - PLACE @ PRESCOTT		FACILITY NUMBER:	013420552
ADMINISTRATOR:	FORD, IANTHA		FACILITY TYPE:	850
ADDRESS:	920 CAMPBELL ST		TELEPHONE:	(510) 874-3333
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94607
CAPACITY:	24	CENSUS: 5	DATE:	02/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Iantha Ford		TIME COMPLETED:	02:30 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 02/16/2023 at 12:00PM Licensing Program Analyst (LPA), A. Curry conducted an unannounced random inspection. LPA met with head teacher, Iantha Ford. This is a preschool age program licensed for 24 children which operates Monday – Friday from 8:30 AM – 3:00 PM. Per the head teacher there are 16 children enrolled. LPA A. Curry began facility tour. All areas identified on the facility sketch were inspected. LPA observed 5 children with 2 staff. Teacher-child ratios were observed to be in accordance with Title 5 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times. LPA observed the facility to be clean, safe, sanitary and in good repair. Furniture and equipment was inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, "sick room" is used as an isolation area. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted. There is drinking water available in all indoor classrooms and drinking containers are taken outdoors. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Facility did not have a functioning carbon monoxide detector (See 809D). The head teacher stated the old carbon monoxide detector was malfunctioning and a new one will be brought soon. The licensee takes measures to keep the facility free of flies, other insects and rodents.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley Curry	TELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

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: OUSD - PLACE @ PRESCOTT	FACILITY NUMBER: 013420552
	VISIT DATE: 02/16/2023

NARRATIVE

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Outdoor play equipment was observed to be in good condition. LPA did not observe any bodies of water during this visit. The head teacher states there are no weapons or firearms on the premises.

LPA verified that Sign in and out sheets are electronic. Staff Records and Children’s Records were reviewed. Verification of CPR/First Aid and health preventative practices documentation was reviewed.

Licensee 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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights were give, and report was reviewed with Iantha Ford

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley Curry	TELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/16/2023 01:04 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: OUSD - PLACE @ PRESCOTT	FACILITY NUMBER: 013420552
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.954

Licensure Requirements

Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above by ensuring there is one more working carbon monoxide detectors, which poses/posed a potential health, safety or personal rights risk to persons in care. Staff indicated the facility had a malfunctioning carbon monoxide detector and is waiting for a new one.
	POC Due Date: 03/03/2023
	Plan of Correction
1 2 3 4	By 03/03/2023 staff will install and send LPA a video that shows new carbon monoxide detector being tested.

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: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley Curry	TELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

LIC809 (FAS) - (06/04)

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