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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405699
Report Date: 07/22/2019
Date Signed: 07/22/2019 12:11:50 PM

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:HAPPY LION DAY CARE CENTERFACILITY NUMBER:
073405699
ADMINISTRATOR:CAHVIS, WEDNESDAYFACILITY TYPE:
840
ADDRESS:2929 CASTRO ROADTELEPHONE:
(510) 734-9119
CITY:SAN PABLOSTATE: CAZIP CODE:
94806
CAPACITY:55CENSUS: 8DATE:
07/22/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Wednesday ChavisTIME COMPLETED:
12:40 PM
NARRATIVE
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An unannounced Annual/Required site inspection was conducted by LPA Susan Neeson. Met with Wednesday Chavis, Licensee and Director. Visit began at 8 AM. All staff are fingerprint clear. There are 8 children present.

Visit was required due to a serious lack of supervision that occurred in 2018 in which a child exited the facility and was able to get some distance away before being observed and returned.

Toured the facility. The yard is used on a scheduling basis. The climbing structures have resilient material under them. There are sufficient toys and equipment for the school age children. Children are transported in a van to and from school. Privacy is available for the school age children when using the bathroom. Some of the school age children need diaper changing and items for this are stored in the bathroom.

Licensee is reminded that ALL assistants, volunteers or adults that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov and for day care updates visit www.myccl.ca.gov

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 An exit interview was given. Wednesday Chavis states that there are no children currently enrolled who need IMS.
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2019
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: HAPPY LION DAY CARE CENTER
FACILITY NUMBER: 073405699
VISIT DATE: 07/22/2019
NARRATIVE
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The following documents were issued: Safe Sleep concepts for infants, Safe and healthy diapering, blue immunization form, car seat information, Licensee rights, fire/earthquake drill forms, Department Quarterly Updates for Winter and Spring 2019 and Flu prevention tips.

Requested copies of current LIC 500, LIC 9040 and CPR and First Aid cards for the file.

Deficiencies are cited on LIC 809 D. An exit interview was given.

Appeal Rights were discussed.

SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2019
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: HAPPY LION DAY CARE CENTER
FACILITY NUMBER: 073405699
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/29/2019
Section Cited
CCR
101516,51ab
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In addition to Sections 101216.3(c), (e), (g) and (h), and notwithstanding Sections 101216.3(a), (b), (d) and (f), the following shall apply: (b) There shall be a staffing ratio of one teacher and one aide present to every 28 children in attendance. This requirement was not met in that an aide was supervisinig school age children

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Wednesday Chavis stated that she would submit a plan to have a teacher qualified person persent at all times in the school age classroom. This will be submitted by 7/29/19.
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from 7 to 10 when a teacher staff member arrived.
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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: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2019
LIC809 (FAS) - (06/04)
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