073406655-12-3-2019-02-CC-BNEN-BJHUUM-20191203145345

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073406655
Report Date: 12/03/2019
Date Signed: 12/03/2019 02:53:59 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:	YMCA OF THE EAST BAY - MOUNTAIN VIEW		FACILITY NUMBER:	073406655
ADMINISTRATOR:	KHALAFALLAH, EMAN		FACILITY TYPE:	840
ADDRESS:	1705 THORNWOOD DR		TELEPHONE:	(925) 689-1170
CITY:	CONCORD	STATE: CA	ZIP CODE:	94521
CAPACITY:	50	CENSUS: 38	DATE:	12/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Director Crystal Impeartrice		TIME COMPLETED:	03:10 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 12/3/2019, Licensing Program Analyst (LPA) Brittany Newton and Licensing Program Manager (LPM) Sherelle Johnson met with Program Director Crystal Impeartrice for the purpose of an unannounced annual Site Inspection. This child care is located on Mountain View Elementary school campus in the far back. The Center is a free stand alone building. LPA toured the facility with the Site Supervisor inside and out for a health and safety inspection. A physical census was taken of all children present and crossed referenced with the sign in and out sheets. Upon LPA's initial arrival there was 8 kindergarten children present. By 2:30, more children arrived bringing the census to 38.PHYSICAL PLANT: The Center is equipped with a working telephone, walkie-talkies, working smoke & carbon monoxide detectors, fully charged fire extinguisher, pull down fire alarm devices, and first aid supplies. STAFF AND CHILDREN'S FILES: A review of 3 children and 3 staff records was conducted. All required documentation for staff and children were in the files. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. CLASSROOMS: Furniture & Equipment was age and sized appropriate. The Heating and lighting was adequate. There is drinking water readily available in the classroom. There is adequate storage for children's belongings. The facility appears to be safe, sanitary and in good repair. BATHROOMS &TOILETING AREAS: The bathrooms were toured and toilets flushed properly and all faucets are in working order. There is a separate staff bathroom. There is separate paper towels and liquid soap available for children's use. FOOD SERVICE AREAS: There is a menu posted and there are no cleaning supplies stored with food. The food preparation area is adequately equipped and free of hazards. The kitchen is accessible to children in care but there is 100% supervision by staff at all times. INSPECTION of OUTDOOR PLAY AREA: All climbing equipment is properly anchored to the ground with adequate and appropriate cushioning under them. The play ground is free of miscellaneous debris or hazards such as tree branches, cans, bottles and broken glass. There is drinking water readily available for children and a shaded area is provided for them also. POSTING REQUIREMENTS: All proper documents that need to be posted are posted in a highly visible place for parental review. Disaster Drills are being practiced at least once every 6 months with the last one being conducted on 11/22/2019. CARE & SUPERVISION: Children and staff were counted in each area of the facility to ensure proper ratios and compliance with capacity limits. Child teacher interactions were observed and found to be in accordance with regulations. Staff on site have current CPR/First Aide certificates.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany Newton	TELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

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 - MOUNTAIN VIEW	FACILITY NUMBER: 073406655
	VISIT DATE: 12/03/2019

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Facility is providing Incidental Medical Services (IMS). Currently there are two children on medication. LPA reviewed both children’s facility file.

There are no deficiencies cited today.

Notice of site visit was provided at the time of the inspection and must remain posted for 30 days. Failure to keep this notice posted for the 30 consecutive days will result in an immediate $100 civil penalty.

Exit interview conducted and a copy of this report was left with Crystal Impeartrice.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany Newton	TELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

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