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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070213850
Report Date: 12/12/2022
Date Signed: 12/12/2022 01:23:52 PM


Document Has Been Signed on 12/12/2022 01:23 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:YWCA OF CONTRA COSTA - MARY ROCHAFACILITY NUMBER:
070213850
ADMINISTRATOR:MICHELLE MANNINGFACILITY TYPE:
850
ADDRESS:931 CAVALLO ROADTELEPHONE:
(925) 374-2112
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:89CENSUS: 41DATE:
12/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Michelle ManningTIME COMPLETED:
01:30 PM
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On 12/12/2022 at 9:25 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced Annual Inspection at YWCA of Contra Costa - Mary Rocha. LPA met with Director, Michelle Manning and explained the purpose of today's inspection. LPA was taken on a tour of the facility. During today's inspection, there 41 children in care and 9 staff. (4 teachers and 5 aides) Facility's operating days and hours are Monday to Friday from 8:00 AM - 5:00 PM in 4 Rooms. (Teddy Bear, Roly Poly, Caterpillar, and Part Day classrooms)
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The physical plant was inspected. LPA toured the premises.
Indoor space: 4 classrooms, restrooms, kitchen and pantry were inspected. Director stated that the Part Day room is not being used right now due to limited staff. Director combined Part Day room with the Roly Poly room. During inspection, children were engaged in various activities under the visual supervision of the teachers and aides. 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. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. LPA observed 3 fish tanks and a tank with 2 lizards in the facility. Foods and beverages were stored safely. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. LPA observed a working Fire extinguisher, Smoke and Carbon Monoxide Detectors. Log shows that the last Fire Drill was conducted on October 15, 2022. 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.

Director was reminded Lead Testing needs to be completed and submitted before January 1, 2023. Director stated that testing has been completed and LPA obtain a copy of Lead Testing Report.

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SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2022
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: YWCA OF CONTRA COSTA - MARY ROCHA
FACILITY NUMBER: 070213850
VISIT DATE: 12/12/2022
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Outdoor Space: Outdoor playground was inspected and observed to be fenced and safe. Facility has an approved posted waiver for the playground area to allow no more than 85 children in the yard at one time. The play equipment was maintained in good condition and free of hazards. LPA observed two playground areas for children with age appropriate toys and play structures. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. Shade is provided by way of covered areas. LPA did not observe any bodies of water on the facility. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

File Review: Children sign in and out procedures and logs were reviewed. A sampling of Children and Staff files was taken for review. All files contained required documents. There was at least one Teacher with current certification in Pediatric CPR/First Aid present at the facility during inspection. Children's Roster and personnel report was reviewed and a copy obtained. During record review, it was discovered three employees had background criminal clearance however were not associated to the facility. LPA associated 3 staff member to facility. LPA reminded Director the importance of having staff fingerprint cleared and associated to the facility.



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.

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

Director was 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. *Con't on Page 3*
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: YWCA OF CONTRA COSTA - MARY ROCHA
FACILITY NUMBER: 070213850
VISIT DATE: 12/12/2022
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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/ction-process.

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

Exit interview conducted and report was reviewed with the Director, Michelle Manning. A Notice of Site Visit was given and must remain posted for 30 consecutive days.

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

DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4