073406662-4-14-2023-02-CC-THAR-CQVSRY-20230414140708

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073406662
Report Date: 04/14/2023
Date Signed: 04/14/2023 04:34:59 PM

Document Has Been Signed on 04/14/2023 04:34 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 - WOODSIDE		FACILITY NUMBER:	073406662
ADMINISTRATOR:	LUPE LOPEZ		FACILITY TYPE:	840
ADDRESS:	761 SAN SIMEON DR		TELEPHONE:	(925) 602-0114
CITY:	CONCORD	STATE: CA	ZIP CODE:	94518
CAPACITY:	102	CENSUS: 7	DATE:	04/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	LUPE LOPEZ		TIME COMPLETED:	02:30 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	12:00 PM- LICENSING PROGRAM ANALYST TASHA ALEXANDER MET TODAY WITH CENTER DIRECTOR LUPE LOPEZ FOR AN UNANNOUNCED 1 YEAR/REQUIRED INSPECTION. UPON ARRIVAL THERE ARE 7 SCHOOL AGE CHILDREN PRESENT ALONG WITH 3 STAFF MEMBERS WHICH INCLUDES THE CENTER DIRECTOR. THE FACILITY IS LOCATED ON WOODSIDE ELEMENTARY SCHOOL GROUNDS IN THE BACK OF THE SCHOOL. THE CLASS ROOM/PORTABLE WAS INSPECTED AND HAS AGE APPROPRIATE FURNITURE WHICH APPEARS TO BE IN GOOD REPAIR. THE INDOOR AND OUTDOOR ACTIVITY SPACE APPEARED TO BE IN GOOD REPAIR AND AGE APPROPRIATE. DISINFECTANTS, CLEANING SOLUTIONS, POISONS AND OTHER ITEMS THAT ARE DANGEROUS TO CHILDREN WERE INACCESSIBLE DURING TODAY'S INSPECTION. THE SINKS WERE OBSERVED TO BE IN OPERABLE CONDITION. THE FLOORS ARE FREE OF TRIPPING HAZARDS. AM AND PM SNACKS ARE PROVIDED BY THE FACILITY. A WEEKLY MENU IS POSTED AND IS VISIBLE FOR PARENTS TO REVIEW . THE KITCHEN AREA WAS OBSERVED TO BE CLEAN AND FREE OF EVIDENCE OF RODENTS. SNACKS ARE PROTECTED AGAINST CONTAMINATION. ALL STORAGE CONTAINERS FOR SOLID WASTE HAVE TIGHT FITTING LIDS THAT ARE IN GOOD REPAIR. DRINKING WATER IS AVAILABLE BOTH INDOORS AND OUTDOORS. OUTDOOR ACTIVITY SPACE IS LOCATED ON THE SCHOOL GROUNDS. PLAYGROUND EQUIPMENT WAS OBSERVED TO BE SAFE AND FREE OF HAZARDS WITH APPROPRIATE MATERIAL TO ABSORB FALLS. THE LICENSEE UNDERSTANDS THAT PRIOR TO WORKING OR VOLUNTEERING IN A LICENSED CHILD CARE FACILITY, ALL INDIVIDUALS SUBJECT TO CRIMINAL RECORD REVIEW SHALL OBTAIN A CLEARANCE OR CRIMINAL RECORD EXEMPTION.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023

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 - WOODSIDE	FACILITY NUMBER: 073406662
	VISIT DATE: 04/14/2023

NARRATIVE

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A SAMPLE OF CHILDREN'S RECORDS WERE REVIEWED. FILES REVIEWED CONTAINED EMERGENCY INFORMATION AND MEDICAL CONSENT FORMS. STAFF RECORDS WERE ALSO REVIEWED. TEACHERS PRESENT TODAY MEET QUALIFICATION REQUIREMENTS AND HAVE HEALTH SCREENING FORMS IN FILE. AT LEAST ONE PERSON PRESENT HAS CURRENT CPR & 1ST AID. MANDATED REPORTER CERTIFICATES ARE UP TO DATE.

Licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023

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 - WOODSIDE	FACILITY NUMBER: 073406662
	VISIT DATE: 04/14/2023

NARRATIVE

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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

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/process.

Today, lpa was notified by center director that this facility will be permanently closing as of June 1, 2023

As a result of today's inspection, there are no deficiencies cited today.

An exit interview was conducted. A notice of site visit was posted.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023

LIC809 (FAS) - (06/04)

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