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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405699
Report Date: 07/24/2019
Date Signed: 07/24/2019 06:11:30 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: 19DATE:
07/24/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Wednesday ChavisTIME COMPLETED:
06:30 PM
NARRATIVE
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An unannounced Case Management - Deficiencies site inspection was conducted by LPA Susan Neeson. Visit commenced at 1:30. Met with Wednesday Chavis, Director.

Facility was toured. A sample of children's records were reviewed.

In addition to deficiencies cited, the program needs to submit an update of facility sketch which clearly indicates which classrooms are used by school age children. Waiver request for use of domino room needs to be submitted and granted. Waiver needs to be submitted for electronic sign-in. Request for non-ambulatory child in capacity needs to be submitted.

Also needed is an updated LIC 610 and 308. LIC 500 and LIC 9040 requested.

Based upon observations and records reviewed, deficiencies are cited on LIC 809 D.

Appeal Rights were discussed

An exit interview was given.
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
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 2
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: 07/24/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/25/2019
Section Cited
HSC
1596.99c2
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Fire Clearance Violation - Fire clearance is for ambulatory children only. This requirement was not met because there is a non-ambulatory child present since March 2019.
This is a zero tolerance deficiency.
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Wednesday Chavis states that the child in question will not be present until fire clearance with non-ambulatory authorization.

CP of $150 was assessed.

Failure to correct may result in additional civil penalties.
Type B
07/25/2019
Section Cited
CCR
101216.6a
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Staffing for water activities - There shall be one adult who has a valid water safety certificate on file at the center persent during water activities in or near any body of water.
This requirement was not met in that no staff has a water safety certificate and children are taken to pool daily.
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Wedndsday Chavis states she will continue watter activities until staff has valid water safety certificate.

Failure to correct may result in civil panalties being assessed.
Type B
08/24/2019
Section Cited
HSC
1596.866a1
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Health and Safety Code Section In addition to other required training, at least one director or teacher at each day care center...shall have at least 15(16) hours of health and safety training, This was not met in that only the Director has this qualification.
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Wednesday Chavis states that she will have additional staff qualified by 8/24/19.

Failure to correct may result in civil panalties being assessed.
Type B
08/24/2019
Section Cited
CCR
101230a
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Activities
(a) Each center shall provide a variety of daily activities designed to meet the needs of children in care. This requirment is not met in that there is no substantive programing for the lower functioning children apart from the higher functioning children.
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Wednesday Chavis states that this programing will be changed by 8/24/19. A written plan for programming for the two groups will be submitted by 8/24/19.

Failure to correct may result in civil panalties being assessed.
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: 07/24/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2