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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420964
Report Date: 09/14/2023
Date Signed: 09/14/2023 03:52:45 PM


Document Has Been Signed on 09/14/2023 03:52 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 - EMERYVILLE MARINAFACILITY NUMBER:
013420964
ADMINISTRATOR:WILLIAMS, ROCHELLE LA'RUEFACILITY TYPE:
830
ADDRESS:1275 - 61ST STTELEPHONE:
(510) 601-8674
CITY:EMERYVILLESTATE: CAZIP CODE:
94608
CAPACITY:40CENSUS: 19DATE:
09/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Denia Dobashi TIME COMPLETED:
02:00 PM
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On 09/14/2023 at 11:30 AM, Licensing Program Analysts (LPAs) Christina Watts and Ashley Akinleye conducted an unannounced Annual Inspection at Berkeley YMCA Head Start - Emeryville Marina - Infant Program. LPA met with Site Supervisor, Denia Dobashi and explained the purpose of today's inspection. The Director, Rochelle "La'Rue" Williams was not present during today's inspection. Present during inspection were 19 infant with 6 staff. Site Supervisor stated there are 26 children enrolled. All staff present, caring and supervising children have Criminal Record Clearance. Facility's operating days and hours are Monday to Friday from 7:30 AM - 5:00 PM in 2 Rooms.

Indoor Space: physical plant was inspected and toured with Site Supervisor.
Infants were engaged in various activities under the visual supervision of the teachers, aides. Rooms, restrooms, and in use areas were inspected. Food and feeding bottles were labeled and stored safely. Food storage areas were sanitary, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. Napping area had cribs and was cordoned off from the activity area by dividers. The infant changing table has raised sides that are at least 3 inches in height, has a vinyl changing pad that is at least 1 inch thick and in good condition. Napping equipment is appropriate. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Cabinets, drawers, and rooms used for storage were locked. Floors were clean and free from tripping hazard. LPA observed a working fire extinguisher, smoke and carbon monoxide detectors. Log shows that the last Fire Drill was conducted on 08/18/2023. Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles. Facility’s License, Parents’ Rights Poster PUB 393, Personal Rights, Activity Schedules, and Menus were observed to be posted.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2023
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 4


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 - EMERYVILLE MARINA
FACILITY NUMBER: 013420964
VISIT DATE: 09/14/2023
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*PAGE 2*

Outdoor Space: Outdoor activity space was inspected and observed to be fenced and safe. The play equipment is age appropriate and maintained in good condition and free of hazards. Shade is provided by way of covered areas. There were no bodies of water observed. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

File Review: Sign in and out procedures and logs were reviewed. Facility uses Child Plus for electronic sign in/sign out. A sampling of Infant and Staff files was taken for review. LPA reviewed the Needs and Services Plan for all infants which were updated quarterly. Reviewed Individual Safe Sleep Plan LIC 9227 and Sleep Log for each infant. There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection. A copy of Children Roster and Personnel Report was obtained.

On or before March 30, 2018 any person who works in a child care facility shall complete Mandated Reporter training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. Review of staff files show that staff has completed Mandated Reporter training.


LPA discussed the safe sleep regulations with Site Supervisor and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1 CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. *CON'T ON PAGE 2*

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
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 - EMERYVILLE MARINA
FACILITY NUMBER: 013420964
VISIT DATE: 09/14/2023
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*PAGE 3*

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02C CP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Site Supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

In the areas that were evaluated, no regulatory violations were observed.

Exit interview conducted and report was reviewed with Site Supervisor, Denia Dobashi . A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4