013422032-4-18-2024-52-CC-MESA-D4FP27-20240418105528

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422032
Report Date: 04/17/2024
Date Signed: 04/18/2024 10:55:59 AM

Document Has Been Signed on 04/18/2024 10:55 AM - 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	AB'S PRESCHOOL AND DAYCARE		FACILITY NUMBER:	013422032
ADMINISTRATOR:	AYALEW, MERAT		FACILITY TYPE:	830
ADDRESS:	301 DOWLING BLVD		TELEPHONE:	(510) 564-4276
CITY:	SAN LEANDRO	STATE: CA	ZIP CODE:	94577
CAPACITY:	12	CENSUS: 3	DATE:	04/17/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Licensee/Director Merat Ayalew		TIME COMPLETED:	04:45 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 Wednesday, April 17, 2024 at 9:15 am, Licensing Program Analysts (LPA) Manel Estoesta and Jaleesa Jackson conducted an annual / random visit. LPA met with the Licensee/Director Merat Ayalew at 10:58 am and explained the purpose of today's visit. At the time of LPA's arrival, present were 2 staff (Teacher Aides) and 3 infants. Facility operates from Monday to Friday 6 AM to 6 PM. LPA's toured the facility to conduct a Health and Safety Inspection. The facility is located in the Saint Mary Eritrean Orthodox Church and it is a combination center that has the Preschool Component 013422012. The Licensed Rooms are the Teddy Bear Room, Panda Bear Room and the Infant Room. The classrooms, restrooms, storage room, and office area were inspected. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. The play equipment was maintained in a safe condition and free of hazards. The infant changing tables are placed within arm’s reach of a sink while in use. There were no bodies of water observed. Outdoor activity space is fenced and play equipment were maintained in a safe condition and free of hazards. LPA's reminded the Director that firearms and other weapons shall not be allowed on or stored on the premises of a child care center Director understands the conditions, limitations, and capacity. Director understands that infants shall always be visually supervised and never left unattended. Facility files were reviewed. Staff files were reviewed. Children's files were reviewed.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101430(a)(3)(E)

This requirement is not met as evidenced by: 101430 Infant Care Activities (a) Notwithstanding Section 101230, the following shall apply: 3) All infants shall be given the opportunity to sleep without distraction or disturbance from other activities at the center whenever the infant desires. (E)If an infant falls asleep before being placed in a crib, staff shall move the infant to a crib as soon as possible.
	Deficient Practice Statement
1 2 3 4	Based on the above LPA's observation, at 9:46 am, LPA Estoesta and LPA Jackson oberserved 2 infants (C1 and C2) were sleeping in their respective car seats at the Infant Room floor, next to the cribs. LPA asked Staff Rgbe Haile, "How long they have been sleeping?" Staff stated since they "got here." LPA Estoesta verified today's sign in for C1, no record time but signed by a parent, and C2 sign in was at 6:40 am but no parent signature., the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 04/18/2024
	Plan of Correction
1 2 3 4	At 9:50 am, LPA Estoesta asked Staff Rgbe to removed the infants and placed them in their respective cribs. Staff Rgbe understood and placed the infants in their cribs. LPA Estoesta discussed to the Director the Infant Safe Sleep Regulation and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

Type A

Section Cited

CCR

101439.1(a)(f)

This requirement is not met as evidenced by: 101439.1 Infant Care Center Sleeping Equipment (a) In addition to Section 101239.1, the following shall apply. (f) cribs shall be free from all loose articles and objects, including blankets and pillows.
	Deficient Practice Statement
1 2 3 4	Based on LPA Jackson observation, at 11:37 am, 3 infants were napping in their respective cribs with blankets and pillows on the infants, the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 04/18/2024
	Plan of Correction
1 2 3 4	At 11:40 am, LPA Jackson asked Staff Rgbe and Faye to removed the blankets and pillows. Staff understood and removed the items. LPA Estoesta discussed to the Director the Infant Safe Sleep Regulation and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101416.5(b)(1)(A)

This requirement is not met as evidenced by: 101416.5 Staff-Infant Ratio (b) There shall be a ratio of one teacher for every four infants in attendance. (1) An aide may be substituted for a teacher when all of the following conditions are met: (A) There is a fully qualified teacher directly supervising no more than 12 infants; and......
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta and LPA Jackson observations, at 9:46 am, Staff Rgbe was by herself in the Infant Room with 3 infants. LPA Estoesta verfied her records and she did not have transcript on her file, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta discussed to the Director Staff Infant Ratio, asked a Teacher to supervise the Aide in the infant room and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

Type A

Section Cited

CCR

101229.1(a)(1)

This requirement is not met as evidenced by: 101229.1 Sign In and Sign Out (a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain, and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.....
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta record review, LPA Estoesta verified today's sign in for C1, no record time but signed by a parent, and C2 sign in was at 6:40 am but no parent signature, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 04/18/2024
	Plan of Correction
1 2 3 4	LPA Estoesta asked the Director to have the parents complete the todays sign in during pick up time. LPA Estoesta discussed to the Sign In and Out regulation and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101427(j)

This requirement is not met as evidenced by: 101427 Infant Care Food Service (j) Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date.....
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta and LPA Jackson observation, at 9:49 am, infants milk bottles in the refrigerator were not labeled wth infant's name and date, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta and LPA Jackson discussed to the Director Infant Care Food Service Plan and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

Type B

Section Cited

CCR

101239(f)

This requirement is not met as evidenced by: 101239 Fixtures, Furniture, Equipment and Supplies (f) Solid waste shall be stored, located and disposed of in a manner that will not transmit communicable diseases or odors, create a nuisance, or provide a breeding place or food source for insects or rodents.....
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta observation, at 9:52 am, there was a garbage white bag in the infants room that was not stored and closed properly right below the sink, and the garbage bins did not have lids, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta and LPA Jackson discussed to the Director the Fixtures, Furniture, Equipment and Supplies and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101239

This requirement is not met as evidenced by: 101239 Fixtures, Furniture, Equipment and Supplies (d) The licensee shall provide lamps or lights as necessary in all rooms and other areas to ensure the comfort and safety of all persons in the child care center.....
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta and LPA Jackson observations, at 9:45 am, the hallway ceiling lights to the the Infant Rooms, were turned off or not functioning, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta advised the Director to replace or fix the ceiling lights and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

Type B

Section Cited

CCR

101239(n)

This requirement is not met as evidenced by: 101239 Fixtures, Furniture, Equipment and Supplies (n) Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts....
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta and LPA Jackson observations, at 10 am, one of the cabinet door right below the Teddy Bear Room sink and the Infant Room bathroom were detached, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta advised the Director to fix the doors mentioned by the POC due date and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101439.1(b)(1)

This requirement is not met as evidenced by: 101439.1 Infant Care Center Sleeping Equipment (b) A crib or portable-crib meeting United States Consumer Product Safety Commission safety standards shall be provided for each infant who is unable to climb out of a crib......
	Deficient Practice Statement
1 2 3 4	Based on LPA Jackson observation, at 11:50 am, one of the cribs mattress did not have fitted sheet, the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta and LPA Jackson advised the Director to replaced the sheet that fits the cribs mattress and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

Type B

Section Cited

CCR

101419.2

This requirement is not met as evidenced by: 101419.2 Infant Needs and Services Plan (a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant. (b)The needs and services plan shall be in writing and shall include the following: (1) The individual feeding plan. (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta record review at 10:30 am, all of the infants did not have Infant Needs and Services Plan and LIC 9227 on the infants file, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta advised to have mentioned above forms completion and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101429(a)(B)

This requirement is not met as evidenced by: 101429 Responsibility for Providing Care and Supervision for Infants (a) In addition to Section 101229, the following shall apply. (B)Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:......
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta's record review, at 10:30 am, the Licensee did not have sleep logs for the infants, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta advised the DIrector to complete the Safe Sleep Log requirement and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

Type B

Section Cited

CCR

101170(e)(2)

This requirement is not met as evidenced by:101170 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) ....
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta record review, at 1 pm, Staff Rgbe, Faye, Hiwot and Lakea have active crimilnal record clearance but not associated to the either one of the Licensee's License, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta advised to use Guardian Website and or to complete and LIC 9182 to transfer the staff criminal record clearance, and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101170

This requirement is not met as evidenced by: 101174 Disaster and Mass Casualty Plan (d) Disaster drills shall be conducted at least every six months.......
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta record review, at 11am, the Licensee last fire and disaster drillls over six months ago, 5/15/2023 and 01/4/2020, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta advised the Director to conduct the drills on or before the POC due date and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office. 101439.1

Type B

Section Cited

HSC

1596.8662

This requirement is not met as evidenced by: 1596.8662 Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion (3) On and after January 1, 2018, a person who becomes an administrator or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a) within the first 90 days that he or she is employed at the facility and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training......
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta record review, at 1pm, Staff Rgbe did not have a current Mandated Reporter Training certificate in her file, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta advised to have the staff mentioned to compete the requirement and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

LIC809 (FAS) - (06/04)

Page: 8 of 11

Document Has Been Signed on 04/18/2024 10:55 AM - 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995

This requirement is not met as evidenced by: 1596.7995 Employees or volunteers at day care center; immunization requirements; records; exemptions.......
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta's record review, at 1 pm, Staff RGBE did not have current Influenza Immunization Record and or Declination in her file, the licensee did not comply with the section cited above which posed a potential risk to the health and safety of children in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta advised to have the Staff to complete the above requirement and she need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

Type B

Section Cited

CCR

101415

This requirement is not met as evidenced by: 101415 Infant Care Center Director Qualifications and Duties (d) When the director of an infant care center or the director of a combination center is temporarily away from the center, the director has the authority to delegate his/her responsibilities as specified below:.....
	Deficient Practice Statement
1 2 3 4	Based on LPA Estoesta record review, at 1PM, Licensee did not have a staff delagation of responsiblities, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	LPA Estoesta advised the Director need the develop a Plan of Correction (POC) and need to submit the POC proof to the Regional Office.

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

LIC809 (FAS) - (06/04)

Page: 9 of 11

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
	VISIT DATE: 04/17/2024

NARRATIVE

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LPA's 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 licensee [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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Directors were 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/inspection-process.

LPA's recommended to the Director of the Technical Support Program (TSP) is the non-enforcement service of Community Care Licensing to help providers. TSP does not cite but instead helps providers improve their compliance.

See LIC 9099 D for the Plan of Correction (POC).

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

LIC809 (FAS) - (06/04)

Page: 10 of 11

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE	FACILITY NUMBER: 013422032
	VISIT DATE: 04/17/2024

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LPA Estoesta informed the Director that this report dated 4/17/2024 included a Type A and B Citations which shall be posted for 30 consecutive days as there is an immediate and potential risk to the health, safety, or personal rights of children in care.

Also, LPA's informed the Director to provide a copy of this licensing report dated 4/17/2024 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

For Child Care Transparency Website (Licensing Facility Inspection Reports), please follow the links below.
https://cdss.ca.gov/inforesources/community-care-licensing/facility-search-welcome
https://www.ccld.dss.ca.gov/carefacilitysearch/

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 and report was reviewed with the Licensee/Director Merat Ayalew.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

LIC809 (FAS) - (06/04)

Page: 11 of 11