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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070209900
Report Date: 06/30/2023
Date Signed: 06/30/2023 03:43:32 PM


Document Has Been Signed on 06/30/2023 03:43 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:YWCA OF CONTRA COSTA - RICHMOND CHILDREN'S CENTERFACILITY NUMBER:
070209900
ADMINISTRATOR:KAUR, JASBIRFACILITY TYPE:
850
ADDRESS:3230 MACDONALD AVENUETELEPHONE:
(510) 621-8550
CITY:RICHMONDSTATE: CAZIP CODE:
94804
CAPACITY:59CENSUS: 11DATE:
06/30/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Lisa KingTIME COMPLETED:
03:58 PM
NARRATIVE
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On Friday, June 30, 2023 at 1:05 PM, Licensing Program Analyst (LPA) Caroline Colson met with Lisa King, Substitute Teacher, for an unannounced case management inspection. Danyel Cheathon, Center Director, arrived during the inspection. There are 11 preschool children and 2 staff members. Interviews were conducted. There was an unusual incident when a child was on a swinging on a handlebar on a play structure. The child fell and injured her right arm. The child's right arm was sprained when she fell from the bar of the play structure. The teacher's back was turned away while assisting another child when the incident occurred. The second incident is when two children started to fight in the classroom. One child scratched another child with both hands which injured the second child.

The attached type B deficiencies are being cited today and must be corrected by the due date. This report must be available for public review for 3 years. Licensee was provided a copy of their appeal rights.

An exit interview was conducted and the report was discussed. A site visit notice was posted.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:
DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/30/2023
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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Document Has Been Signed on 06/30/2023 03:43 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612


FACILITY NAME: YWCA OF CONTRA COSTA - RICHMOND CHILDREN'S CENTER
FACILITY NUMBER: 070209900

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/31/2023
Section Cited
CCR
101212(a)(1)

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Reporting Requirements
Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.
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Licensee and all staff will watch the Reporting Requirements on the Department's website at www.ccld.ca.gov and provide a written summary.
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The unusual incidents weren't reported by phone within 24 hours. This requirement is not met as evidenced by the observation and records review during today's inspection.
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Type B
07/31/2023
Section Cited
CCR101229(a)(1)

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Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.

(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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A written plan will be submitted to ensure that the playground and classroom are visually supervised at all times.
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A child was swinging from a handlebar on the play structure. The child injured her right arm without direct supervision. Two children were fighting and one child sustained an injury. This requirement is not met as evidenced by the observation and records review during today's inspection.
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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: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:
DATE: 06/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/30/2023
LIC809 (FAS) - (06/04)
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