015700547-1-13-2022-52-CC-MOTI-CAMQMC-20220113111720

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700547
Report Date: 01/13/2022
Date Signed: 01/13/2022 11:17:30 AM

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:	RISE EAST BAY		FACILITY NUMBER:	015700547
ADMINISTRATOR:	SHAHEIDARI, ELHAM		FACILITY TYPE:	850
ADDRESS:	573 BARTLETT AVENUE		TELEPHONE:	(408) 614-9961
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	30	CENSUS: 0	DATE:	01/13/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Elham Shaheidari		TIME COMPLETED:	11:25 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	A Prelicensing inspection was conducted today 1/13/2022 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met with Applicant, Elham Shaheidari. The applicant has submitted a NEW application for a PRESCHOOL license for 30 preschoolers including up to 10 toddlers in the toddler option program. The program will operate from 7:45AM - 6:00PM, Monday through Friday, in 3 classrooms (Classroom A, Classroom B, and Classroom C/D plus the Assembly Hall). Toddler Room will serve the toddler option program with up to 10 toddlers in Room A. A health and safety inspection was conducted inside and outside and the measurements are as follows: INDOORS: 2174.39 square feet = 62 children OUTDOORS: 11958.20 square feet = 159 children The center has obtained an approved fire inspection clearance from the Alameda County Fire Department on 11/30/2021. The preschool rooms are equipped with varied age appropriate materials and equipment. There are 4 toilets and 5 sinks available for children. Staff toilet is located in the outside hallway. Children are requested to bring lunch from home. Facility will provide AM/PM snacks. Menu will be posted at least one week in advance in a place visible for the authorized representative to see. One of the offices and teacher's bathroom will serve as isolation areas for sick children. Mats were observed today. This facility plans to provide Incidental Medical Services - IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: RISE EAST BAY	FACILITY NUMBER: 015700547
	VISIT DATE: 01/13/2022

NARRATIVE

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The play yards are fenced in all around. Building overhang provides sufficient shade in the play yards. The center has pitchers and cups, as well as water bottles for indoor and outdoor activities. No cleaning agents were found stored with food. There is a refrigerator available. First aid supplies are available in the center. There is a working telephone on site. Facility will utilize an electronic sign in/out software that has a separate PIN/login for each authorized representative. Paper sign in/out sheets will be utilized should the electronic software be unavailable.

Elham Shaheidari is a fully qualified preschool director and has completed 16 hours of health and safety training including pediatric CPR and First Aid. Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 applicant 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 applicant 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: RISE EAST BAY	FACILITY NUMBER: 015700547
	VISIT DATE: 01/13/2022

NARRATIVE

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A license for 30 preschool children (operating out of 3 rooms - A, B, C/D and the Assembly Hall) which includes up to 10 toddlers in the toddler option program will be issued once the following is completed:

- Gates are placed on sides of building to prevent access to children.
- Gates on stairways to prevent access to children.
- Proof of Removal of Play Structure as it is not installed per manufacturer instructions and not appropriate for age range. OR Proof of Play Structure installed per manufacturer instructions and a toddler outdoor play space is created to prevent use of play structure.
- Proof of installed and operable carbon monoxide detector.

Applicant is to submit proof of the above being completed to LPA no later than 2/1/2022.

Exit interview conducted and report was reviewed with the applicant, Elham Shaheidari.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

LIC809 (FAS) - (06/04)

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