015700534-6-24-2021-52-CC-MOTI-C4ASHS-20210624135401

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700534
Report Date: 06/24/2021
Date Signed: 06/24/2021 01:54:06 PM

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:	CAPE CAL SAFE BURKE CENTER		FACILITY NUMBER:	015700534
ADMINISTRATOR:	ALMAND, ROSEMARY		FACILITY TYPE:	830
ADDRESS:	612 WEST A STREET		TELEPHONE:	(925) 443-3434
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	16	CENSUS:	DATE:	06/24/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Regina Garcia		TIME COMPLETED:	02:20 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	A Prelicensing Visit was conducted today by Licensing Program Analyst (LPA), Melanie Otsuji. LPA met with Applicant, Regina Garcia, and Director, Vanessa Coriel. The applicant has submitted an application for an INFANT license with the option to have up to 16 toddlers in the toddler option room (Room B). A health and safety inspection was conducted inside and outside. The infant program will operate in 2 classrooms. Operating Monday through Friday from 8:00AM - 5:00PM. The measurements are as follows: INDOORS: 1182.54 square feet = 34 children OUTDOORS: 7102.92 square feet = 95 children Classrooms are equipped with varied age appropriate materials and equipment. The diaper changing tables are within arms reach of a sink. There are 4 sinks and 3 toilets available for children. The office and staff bathroom will serve as isolation area for ill children. There is a total of 1 play yard for the infant aged children to utilize. The yard is fenced in all around. Yards with high climbing equipment are cushioned with poured rubber and/or grass. Canopies and/or trees provide sufficient shade in all play yards. Breakfast/Lunch and snacks are provided to the infants. There are food preparation areas in each classroom. Cabinets with cleaners are locked and/or inaccessible to prevent access to children. The sign in/out sheet allows for parents' full legal signature and records the date and time of day. This facility plans to provide Individual Medical Services – IMS. When any changes to IMS is made a new plan 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

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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: CAPE CAL SAFE BURKE CENTER	FACILITY NUMBER: 015700534
	VISIT DATE: 06/24/2021

NARRATIVE

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Vanessa Coriel is a fully qualified infant director and has completed 16 hours of health and safety training including pediatric CPR and First Aid. There is a working telephone on site. The center has obtained an approved fire safety inspection on 01/13/2021 for 20 children.

Zero Tolerance policies were explained. The center was found to be clean, safe, sanitary, and in good repair. A license for 20 infants with the option to have up to 16 toddlers is recommended effective today, 6/24/2021. Infants will be in Room A and Toddlers in Room B.

An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

LIC809 (FAS) - (06/04)

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