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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406655
Report Date: 03/14/2023
Date Signed: 03/14/2023 02:09:16 PM


Document Has Been Signed on 03/14/2023 02:09 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 - MOUNTAIN VIEWFACILITY NUMBER:
073406655
ADMINISTRATOR:KHALAFALLAH, EMANFACILITY TYPE:
840
ADDRESS:1705 THORNWOOD DRTELEPHONE:
(925) 689-1170
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY:50CENSUS: 0DATE:
03/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:24 PM
MET WITH:Jennifer CruzTIME COMPLETED:
02:23 PM
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On 3/14/2023, Licensing Program Analysts (LPAs) Melissa Guirit and Melissa Domantay made an unannounced required annual inspection at the above facility. LPAs met with Director, Jennifer Cruz. There were children or other staff present during today's inspection. The entire facility was toured to conduct a health and safety inspection. Facility operates Monday through Friday from 11:00am-6:00pm. LPAs toured the classroom/portable, which is located in the back right of the school campus.

The school age program operates in one portable. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. There is a private restroom for children was observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers and were in good repair. LPAs observed a 3A40BC Fire extinguisher, smoke detector and carbon monoxide Detector. The last Fire Drill was conducted on 02/2023. Director is reminded that fire drills should be conducted at least every 6 months. The center is equipped with a fully stocked first aid kit and working telephone. Facility does not provide transportation for preschool children, but Director understands that children cannot be left alone, unattended in parked vehicles. Facility’s License, Parents’ Rights Poster PUB 393, Personal Rights, Activity Schedules, and menus were observed to be posted. Facility provides afternoon snacks for children. Isolation area for sick children will be at the teacher's desk.

Outdoor playground was inspected and observed to be fenced and safe. The play equipment was maintained in good condition and free of hazards. Areas around the outdoor play yard are cushioned with material that absorbs falls. Shade is provided by way of covered areas. There were no bodies of water observed during today's inspection. Drinking water is arranged to be readily available to children during indoor and outdoor activities. Children utilize persona; reusable water bottles. See 809-C for continuance.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa GuiritTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2023
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: YMCA OF THE EAST BAY - MOUNTAIN VIEW
FACILITY NUMBER: 073406655
VISIT DATE: 03/14/2023
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Children sign in and out procedures and logs were reviewed. Facility uses manual sign in/sign out procedure. LPAs reminded facility to maintain sign in/sign out procedures and make sure parents/authorized representatives sign the child in and out. Six children's files and three staff files were reviewed and contained required documents. Director, Jennifer Cruz has a valid CPR/First Aid Certificate, expires on 11/6/2023. Children's Roster and staff personnel report was reviewed. A copy of staff personnel report and children's roster were provided to LPAs by Director, Jennifer Cruz.

On or before March 30, 2018 any person who works in a child care facility shall complete Mandated Reporter training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

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

Director 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

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/ction-process.

There are no deficiencies cited today. Exit interview conducted and report was reviewed with Director, Jennifer Cruz. A Notice of Site Visit was given and must remain posted for 30 consecutive days.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa GuiritTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023
LIC809 (FAS) - (06/04)
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