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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010215822
Report Date: 11/05/2024
Date Signed: 11/05/2024 03:00:15 PM

Document Has Been Signed on 11/05/2024 03:00 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:YMCA OF THE EAST BAY Y-KIDS FOREST PARKFACILITY NUMBER:
010215822
ADMINISTRATOR/
DIRECTOR:		KINCHELOE, JENNIFERFACILITY TYPE:
840
ADDRESS:34402 MAYBIRD CIRCLETELEPHONE:
(510) 793-2630
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 62TOTAL ENROLLED CHILDREN: 72CENSUS: 7DATE:
11/05/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Sonika KarwaTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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On 11/5/2024 at 10:00AM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted an Unannounced Annual/Random Inspection and met with Teacher Sonika Karwa. LPA informed the Facility Representative the nature of the inspection and was granted entry into the facility. There were 3 school aged children present during this inspection and two fingerprint cleared staff. At 11:20AM the 3 school aged children were taken to PM Transitional Kindergarten and at 11:25AM 4 different school aged children pick up from AM Transitional Kindergarten. Director Chaitali Bandyopadhyay was not present for today's inspection. The facility consist of 1 classroom and has a preschool component #13422018. The facility was toured for a health and safety inspection. The hours of operation are Monday - Tuesday, Thursday - Friday from 7AM - 8:30AM then 1:45PM - 6:00PM. On Wednesdays the hours are modified for early release 7AM - 8:30AM then 11:45AM - 6:00PM.

The programs are both run out of a portable on the Forest Park Elementary School campus. There are adequate play and learning materials available. LPA observed all the floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is the office area in the corner of the room away from other children in care. The center has working smoke detectors, carbon monoxide detector, working telephone, and 2 fully charged 3A40BC fire extinguishers. The staff's bathroom is separate from the children's bathroom. All sinks and faucets are in safe and sanitary operating condition.

This facility provide snacks for the children. On Wednesdays lunch is provided by the elementary school or children bring their lunch from home. There are weekly menus posted at the facility. All storage containers for solid waste have tight fitting covers that are in good repair.
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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2024
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YMCA OF THE EAST BAY Y-KIDS FOREST PARK
FACILITY NUMBER: 010215822
VISIT DATE: 11/05/2024
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The outside play yard is clean with age-appropriate materials for the children. The facility uses the far-right play structure on the elementary school grounds. The play yard is also open to the public park. There is plenty of shade and the play structure has ample cushion for extra safety. LPA did not observe any harmful or unattended bodies of water in or around the facility.

LPA review 3 children's files and 2 staff files. At least one opening/ closing staff member has a current CPR & First Aid Certificate. The facility uses a paper sign in/out sheet for the children’s parents and authorized representatives. LPA reviewed that all children were signed in correctly. The facility conducts and documents disaster drills at least every 6 months. The last drill was documented 10/17/2024.

There were no deficiencies cited during today's visit.

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.

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.



Continued on 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2024
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YMCA OF THE EAST BAY Y-KIDS FOREST PARK
FACILITY NUMBER: 010215822
VISIT DATE: 11/05/2024
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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 PIN 21-21.1-CCP.

LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.



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/.

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.



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 Sonika Karwa.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2024
LIC809 (FAS) - (06/04)
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