073407414-7-28-2021-52-CC-MPRE-C5CUEE-20210728153100

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073407414
Report Date: 07/28/2021
Date Signed: 07/28/2021 03:31:07 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	YMCA CHILDCARE - GOLDEN VIEW		FACILITY NUMBER:	073407414
ADMINISTRATOR:	EWING, KELLY		FACILITY TYPE:	840
ADDRESS:	5025 CANYON CREST DR		TELEPHONE:	(925) 735-3981
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94582
CAPACITY:	115	CENSUS:	DATE:	07/28/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Jennifer Williams		TIME COMPLETED:	03:30 PM

NARRATIVE

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On 7/28/2021 at 12:20pm Licensing Program Analyst (LPA) Morgan Pringle met with Director Jennifer Williams and Assistant Director Daniela Ambriz for an Unannounced Annual Inspection. The facility was toured for a health and safety inspection. There were seven (7) teachers and fifteen (15) school age children present during the inspection.

The facility has age appropriate materials that was observed to be clean and in good condition. All outdoor spaces have proper shading for children. Most toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas (See LIC 809-D). All sinks and toilets were observed to be clean and in proper working order. The kitchen/food preparation area was observed to be clean.

The facility is operating within its licensed capacity. The facility is also within ratio today. LPA did not observe any bodies of water at the facility.

LPA obtained the facility roster and a sample of the children’s files and the staff files. All children’s files were observed to be complete. All staff files were not complete. File and disaster drill log was obtained and the last drill was logged on 7/2021.

Director reminded that ALL staff and 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 $3,000 per person, per incident. Owner was reminded of the responsibility as a mandated reporter.

Deficiencies being cited: 101217(a) and 101238(g)

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: YMCA CHILDCARE - GOLDEN VIEW	FACILITY NUMBER: 073407414
	VISIT DATE: 07/28/2021

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All fire/disaster drill must be conducted every six months and documented. The Director is reminded that any structural changes to the facility or additions to the childcare facility must be reported to Community Care Licensing.

Director was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

This report was read and given to the Director for a signature. There are two (2) deficiencies being cited today. This report shall remain on file for 3 years. Appeal Rights were provided and exit interview conducted. A Notice of Site visit was given and must be posted for 30 days.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: YMCA CHILDCARE - GOLDEN VIEW	FACILITY NUMBER: 073407414
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/28/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/28/2021 Section Cited	1 2 3 4 5 6 7	101217(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	There are three incomplete staff files at the facility. This poses a potential risk to the health and safety to children in care.	8 9 10 11 12 13 14
Type B 07/28/2021 Section Cited	1 2 3 4 5 6 7	101238(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Cabinet under the sink in the classoom and shelves in the staff bathroom are unlocked. Making them accessable to the children in care. This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

LIC809 (FAS) - (06/04)

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