073407443-4-7-2023-02-CC-MDOY-CQLUB4-20230405152543

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073407443
Report Date: 04/05/2023
Date Signed: 04/07/2023 04:54:57 PM

Document Has Been Signed on 04/07/2023 04:54 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:	ST. PAUL PRESCHOOL		FACILITY NUMBER:	073407443
ADMINISTRATOR:	BARTLETT, SARAH		FACILITY TYPE:	850
ADDRESS:	1825 CHURCH LANE		TELEPHONE:	(510) 233-3080
CITY:	SAN PABLO	STATE: CA	ZIP CODE:	94806
CAPACITY:	21	CENSUS: 7	DATE:	04/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Ileana Gonzalez		TIME COMPLETED:	02:50 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 4/5/23, Licensing Program Analysts (LPAs) Melissa Domantay and Melissa Guirit met with Teacher Ileana Gonzalez for a Required 1 Year inspection. The facility preschool center and playground were toured to conduct a Health and Safety Inspection. Present during today's inspection was Teacher, Ileana Gonzalez. There were 7 preschool children present during today's inspection. Director is out on vacation. All adults present today are fingerprint cleared and associated. The program is located in one classroom (Preschool Classroom) on the grounds of St. Paul School. The center operates Monday through Friday from 7:30am to 3:30pm. LPAs toured the premises with Teacher Ileana. 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. The preschool children use the school children's bathrooms with staff supervision present at all times to ensure that preschool children do not use the bathrooms at the same time as older age children. There is a waiver on file for use of the school bathrooms. Restrooms for children were 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 and Carbon Monoxide Detector. The last Fire Drill was conducted on 3/14/2023. Teacher Ileana 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 Teacher Ileana understands that children cannot be left alone, unattended in parked vehicles. Outdoor playground was inspected and observed to be fully fenced, safe, and designated for preschool use only so that preschool children do not commingle with older age group children. There is one piece of high climbing equipment/slide which is securely anchored with cushioning under/around the structure. There are no pools or other bodies of water accessible to children during today's inspection. 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. See 809-C for continuance.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa Domantay	TELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

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: ST. PAUL PRESCHOOL	FACILITY NUMBER: 073407443
	VISIT DATE: 04/05/2023

NARRATIVE

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Facility’s License, Parents’ Rights Poster PUB 393, Personal Rights, and Activity Schedules were observed to be posted. Food is provided from home for children. Corner by Library will be used for the isolation of sick children. Drinking water is arranged to be readily available to children during indoor and outdoor activities. Children utilize personal reusable water bottles. Children sign in and out procedures and logs were reviewed. Facility uses electronic 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. (3) Children's files and (2) Staff files were reviewed and contained required documents. Teacher Ileana has a valid CPR/First Aid Certificate, expires on 08/2024. Children's Roster and staff personnel report was reviewed. A copy of staff personnel report and children's roster were provided to LPAs by Teacher Ileana.

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

Teacher Ileana 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. 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.

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 Teacher, Ileana Gonzalez. A Notice of Site Visit was given and must remain posted for 30 consecutive days.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa Domantay	TELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

LIC809 (FAS) - (06/04)

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