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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405697
Report Date: 06/23/2021
Date Signed: 07/08/2021 11:08:09 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:FIRST BAPTIST HEAD START - EAST LELAND COURT CTR.FACILITY NUMBER:
073405697
ADMINISTRATOR:ACOSTA, RAMONAFACILITY TYPE:
850
ADDRESS:2555 EAST LELAND ROADTELEPHONE:
(925) 473-2035
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY:36CENSUS: DATE:
06/23/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ramona CarrilloTIME COMPLETED:
05:00 PM
NARRATIVE
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** Amended Report** On 06/23/21 at 2:00 PM Licensing Program Analysts (LPAs) Michelle Sutton and Monica Mathur conducted an unannounced Case Management inspection about an unusual incident self reported by the Center about a child left unattended in the playground. LPAs met with site supervisor Ramona Carrillo and explained the purpose of today's inspection. All rooms were in ratio compliance during today's inspection.

LPAs interviewed the site supervisor, staff and staff files were reviewed. LPAs also observed the toddler 2B classroom. Copies of The Children's Roster, Personnel Report LIC500 and incident written statements were obtained. During the inspection, it was determined that child C1 was left outside attended in the play yard while teachers S1 and S2 walked 5 other children into the classroom and shut the door. Staff S3 was watching this incident from adjacent play yard and brought the child back into the classroom. Child was alone for 45 seconds to a minute. S3 had visual on the child at all times. Facility is being cited Type B for lack of supervision.

Exit Interview was conducted, where this report, deficiencies, and appeal rights was reviewed and discussed with the site supervisor.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: FIRST BAPTIST HEAD START - EAST LELAND COURT CTR.
FACILITY NUMBER: 073405697
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/23/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed


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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: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:
DATE: 06/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/23/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: FIRST BAPTIST HEAD START - EAST LELAND COURT CTR.
FACILITY NUMBER: 073405697
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/23/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/30/2021
Section Cited

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101229 Responsibility for Providing Care & 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. Supervision shall include visual observation. This requirement is not met as evidenced by:
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Per LPAs investigation, Child 1 (C1) ws left unattended in the play yard while teachers S1, S2 and rest of children went back inside. Staff S3 was positioned in the adjacent play yard and watched C1 being left behind. S3 went over and brought C1 back to the classroom. C1 was by himself for no more than 45 secs - 1 min while S3 had constant visual of C1. This posed a potential risk to safety of child.
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Type B
07/06/2021
Section Cited

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101212 Reporting Requirements (b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement is not met as evidenced by:
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Per LPA observation, there is no designated person for facility responsibilities in the absence of Site Supervisor. This is a potential risk to health and safey of children.
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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: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle SuttonTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:
DATE: 06/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/23/2021
LIC809 (FAS) - (06/04)
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