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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410800
Report Date: 07/20/2023
Date Signed: 07/21/2023 11:57:00 AM


Document Has Been Signed on 07/21/2023 11:57 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 07/21/2023 11:53 AM

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

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**THIS IS AN AMENDED REPORT** On today's date, 7/20/2023 Licensing Program Analyst (LPA) Melanie Otsuji conducted an ANNOUNCED 1 YEAR REQUIRED INSPECTION and CAPACITY INCREASE/ROOM ADDITION. The center has requested to add room 3 as licensed space and increase capacity from 64 preschool aged children to 88 preschool aged children. The preschool program is located on Theuerkauf Elementary School campus. The program is currently utilizing the three portable classrooms which are rooms 23, 24, and 25. LPA met with Applicant, Terri Kemper. The facility was toured to conduct a Health and Safety Inspection. This program operates Monday through Friday: 8AM-3PM. Facility operates on the Mountain View Whisman School District Calendar therefore is currently closed for the summer. Facility will reopen on August 9, 2023

The preschool classrooms were inspected for age appropriate furnishings, equipment, and adequate storage for children’s belongings. LPA observed the presence of working carbon monoxide detector, smoke detectors/fire alarms and fully charged fire extinguishers that is accessible throughout the facility. There are no pools, hot tubs or other accessible bodies of water. Cleaning supplies/toxins are stored inaccessible to children during the inspection and all required postings are present. The facility provides breakfast and lunch from the school district. Children bring their own water bottles from home and the facility refills them with a water dispenser. LPA observed the preschool play yard and observed trees for shade. No hazards were observed on the play yard on today's date. LPA reviewed Director's file. Staff interview also conducted and documented. LPA reviewed 5 staff files and 5 children files.
To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:
DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: BARACK & MICHELLE OBAMA PRESCHOOL AT THEUERKAUF
FACILITY NUMBER: 434410800
VISIT DATE: 07/20/2023
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Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in https://www.cdss.ca.gov/Portals/9/CCLD/PINs/2021/CCP/PIN-21-21_1-CCP.pdf. LPA referred facility representative to the Department website for lead: https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
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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: BARACK & MICHELLE OBAMA PRESCHOOL AT THEUERKAUF
FACILITY NUMBER: 434410800
VISIT DATE: 07/20/2023
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 Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No citations are noted on today's date. A license with approval for 88 preschool aged children operating out of three portable classrooms (23, 24, and 25) and Classroom #3 will be issued effective, 7/20/2023.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Terri Kemper.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC809 (FAS) - (06/04)
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