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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013414174
Report Date: 06/12/2023
Date Signed: 06/12/2023 12:40:55 PM

Document Has Been Signed on 06/12/2023 12:40 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:S.S.U.C. - THURGOOD MARSHALL EARLY HEADSTARTFACILITY NUMBER:
013414174
ADMINISTRATOR:DEMELLO, NINAFACILITY TYPE:
830
ADDRESS:1117 - 10TH STREETTELEPHONE:
(510) 836-0543
CITY:OAKLANDSTATE: CAZIP CODE:
94607
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 5DATE:
06/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Amal WahbaTIME COMPLETED:
01:00 PM
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On June 12, 2023 at approximately 09:20 AM., Licensing Program Analysts (LPAs) Lorraine Dacanay Breaux and Jyoti Saini conducted an unannounced Annual Required Inspection and met with facility representative, Amal Wahba. LPAs disclosed the purpose of the inspection and was granted entry into the facility. There were five (5) toddlers age children present during this inspection and three (3) additional staff members. The facility was toured for a health and safety inspection. This facility has a dual license - day care component (#13414173), facility is a HEADSTART Program. The hours of operation are 08:00 AM-04:15 PM, Monday - Friday. This facility does not have infants enrolled at this time.

CLASSROOMS: All classrooms were inspected. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation, and lighting. The facility provides drinking water and is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is in the classroom (quiet area). The center has a wired smoke detector, a carbon monoxide detector, working telephone, fire alarm system, and (3) fully charged 3A40BC fire extinguishers.

BATHROOMS AND TOILETING AREAS: The staff's bathroom is separate from the children's bathroom. All sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets. Diaper changing table is in the classroom and is in arm reach of the sink. Supplies are available to the children.

FOOD SERVICE AREAS: There is a kitchen area. This facility provides meals and snacks for the children. There are weekly menus posted at the facility. LPAs observed an area where they have a refrigerator this area is clean and free of evidence of rodents. All storage containers for solid waste are in good repair. LPAs reminded facility representative to ensure that food containers are labeled with expiration dates.

See 809-C

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: S.S.U.C. - THURGOOD MARSHALL EARLY HEADSTART
FACILITY NUMBER: 013414174
VISIT DATE: 06/12/2023
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OUTDOOR PLAY AREAS: The school has a playground area. There's a play structure that is anchored with cushioning to absorb children's falls. All outdoor play structures are anchored and in good condition. There is are canopies to provide shade.

RECORDS: LPAs requested and obtained files for review. All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Children's files and all staff files were reviewed. All staff files have required Health Screening and Employee Rights. All children's files contained Identification & Emergency, Personal Rights, and Medical Consent forms. (This program uses their own forms) LPAs reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed, and certificates were reviewed. The center is following the sign in and out procedure. Disaster drills are being conducted at least once every 6 months at the last one conducted was on 06/08/23. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: The center is equipped with a fully stocked first aid kit that is available in each classroom. There is no medication being administered at this time.

California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

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.

See 809-C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: S.S.U.C. - THURGOOD MARSHALL EARLY HEADSTART
FACILITY NUMBER: 013414174
VISIT DATE: 06/12/2023
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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

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.

Facility representative 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.

No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the facility representative, Amal Wahba.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
LIC809 (FAS) - (06/04)
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