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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416021
Report Date: 09/19/2025
Date Signed: 09/19/2025 04:23:23 PM

Document Has Been Signed on 09/19/2025 04:23 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LITTLE STARS PRESCHOOLFACILITY NUMBER:
013416021
ADMINISTRATOR/
DIRECTOR:		LEE, WILLIAMFACILITY TYPE:
830
ADDRESS:169 - 14TH STREETTELEPHONE:
(510) 286-9800
CITY:OAKLANDSTATE: CAZIP CODE:
94612
CAPACITY: 13TOTAL ENROLLED CHILDREN: 13CENSUS: 10DATE:
09/19/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Khamsay "Kim" SalyphanhTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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On 09/19/2025 at 09:50 AM Licensing Program Analyst (LPA) A. Hollinger conducted an Unannounced, Annual Random Inspection at Little Stars preschool. LPA met with Head Teacher, Khamsay "Kim" Salyphanh and explained the purpose of today's inspection. Present during today's inspection were Head Teacher Khamsay "Kim" Salyphanh, three (3) Teaching Staff, who are all fingerprint cleared, and ten (10) infants. LPA was granted inspection authority to enter the facility. The facility was toured to conduct a Health and Safety Inspection. The facility's days and hours of operation are Monday - Friday, 7:30 AM - 5:30 PM.

Indoor Space operates out of one (1) classroom, Baby Stars.

Outdoor Space - Outdoor playground and activity space was inspected and observed to be fenced and safe. The play equipment is age appropriate and maintained in good condition and free of hazards. There were no bodies of water observed. Drinking water is readily available to children during indoor and outdoor activities via individual water bottles.

The facility was observed to be in compliance with teacher to children ratio requirement during inspection. LPA toured and inspected the physical plant. LPA observed that all areas have sufficient lighting, heating and ventilation for the safety and comfort of children and staff. The classrooms, restrooms, food storage areas and spaces accessible to children were inspected.

LPA observed disinfectants, cleaning solutions, poisons and other items that are dangerous to the health and safety of children in care were stored in places inaccessible to them during today's inspection.

SEE LIC809C-----------------------------------------------------------------------------------------------------------------------------

NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Ashley Hollinger
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: LITTLE STARS PRESCHOOL
FACILITY NUMBER: 013416021
VISIT DATE: 09/19/2025
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Cabinets, drawers, and rooms used for storage were locked. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. There are separate bathrooms for staff and children were observed; all toilets, and hand washing sinks are observed to be in safe and sanitary operating condition. All floors were clean and safe. LPA reminded the Director that all children should have 100% supervision when utilizing the bathroom. Trash cans for solid waste had tight-fitting covers on and were in good repair. The facility provides snacks and lunch to children in care.

The facility is equipped with a 3A40BC fire extinguisher located near the front entrance and in the kitchen. The facility also has pull down fire alarms, a centralized smoke and carbon monoxide detection system with detectors in each classroom, at least one working telephone, and first aid supplies in each classroom. LPA did not observe any hazardous items, toxins, bodies of water or medication accessible to children during today's inspection.

File Review: Children sign in/out procedures and logs were reviewed. LPA observed facility uses an electronic application for sign in/out procedures. A sample of five (5) Children's files and four (4) Staff files were reviewed. A copy of Children Roster was obtained for each component. The last documented fire and earthquake drill was conducted on 05/23/2025.

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 21-21.1CCP). LPA verified that the lead testing was last completed on 12/04/2022 and is in accordance to PIN 21-21.1-CCP.

Staff were 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.


SEE LIC809C-----------------------------------------------------------------------------------------------------------------------------
NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Ashley Hollinger
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: LITTLE STARS PRESCHOOL
FACILITY NUMBER: 013416021
VISIT DATE: 09/19/2025
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LPA discussed the safe sleep regulations with Director and the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed Director 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information, see PIN 22-02-CCP. 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-carecenters/.

No Deficiencies were observed during the inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Head Teacher, Kim Salyphanh.

NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Ashley Hollinger
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2025
LIC809 (FAS) - (06/04)
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