073405695-6-17-2022-02-CC-CCON-CFGUH8-20220617153530

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073405695
Report Date: 06/17/2022
Date Signed: 06/17/2022 03:35:38 PM

Document Has Been Signed on 06/17/2022 03:35 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:	YMCA OF THE EAST BAY - RICHMOND CDC		FACILITY NUMBER:	073405695
ADMINISTRATOR:	TA-TANISHA HIVES		FACILITY TYPE:	830
ADDRESS:	485 LUCAS AVENUE		TELEPHONE:	(510) 370-4665
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94801
CAPACITY:	32	CENSUS: 15	DATE:	06/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:16 AM
MET WITH:	Ta-Tanisha Hives		TIME COMPLETED:	03:50 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 Friday, June 17, 2022 at 10:16 AM, Licensing Program Analyst (LPA) Caroline Colson, arrived at the facility and met with Ta-Tanisha Hives, Center Director to conduct an annual required inspection. A Health and Safety Inspection was conducted. The hours of operation are Monday - Friday from 7:00 AM to 5:00 PM. LPA made the following observations: Capacity/Staffing: There are 15 infants with 10 staff members including the director. Physical Plant: There are two classrooms for the Infant Program. All bathrooms were inspected. There is adequate heating, lighting and ventilation. There are no cleaning solutions, chemicals or other hazards accessible to children. Classrooms: Furniture and equipment age appropriate and in good repair. There are separate storage areas for children’s belongings. Children nap at the facility. There are three (3) cribs for younger infants. There are cots and bedding materials for the older infants. Bedding materials are washed every day by the facility. The menu is posted for review. Restrooms: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use. The changing table is within arm's reach of a sink. Play yard: Climbing structures, slides are safe and in good condition. Playground is free of debris and other hazards. Drinking water is readily available. There are no pools, hot tubs or other bodies of water present. Please LIC 809 C for additional information

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

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: YMCA OF THE EAST BAY - RICHMOND CDC	FACILITY NUMBER: 073405695
	VISIT DATE: 06/17/2022

NARRATIVE

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Emergency Preparedness/Safety: Smoke detector was inspected by an outside company. Carbon monoxide detector was tested and is working. There is a 2A10BC fire extinguisher and was serviced in October 2021. Pediatric CPR and First Aid Certificates are current and expire on December 11, 2023. First Kit is available and complete. Emergency Disaster Plan is posted. The facility utilizes a land line telephone.

Postings: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist in each classroom.

Sign in Sheet/Class Roster: All parents use electronic signatures to sign in and sign out. The roster is current and available.

Training/Record Review:
All staff present on this date have criminal background clearances. Immunization records including influenza and or a statement declining vaccination are on file.

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

Ta-Tanisha Hives 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.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

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: YMCA OF THE EAST BAY - RICHMOND CDC	FACILITY NUMBER: 073405695
	VISIT DATE: 06/17/2022

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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/process.

As a result of this inspection, there are no deficiencies cited during today's inspection.

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, Ta-Tanisha Hives.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

LIC809 (FAS) - (06/04)

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