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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420975
Report Date: 01/18/2023
Date Signed: 01/18/2023 12:24:18 PM

Document Has Been Signed on 01/18/2023 12:24 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:ACADEMIA DE MI ABUELAFACILITY NUMBER:
013420975
ADMINISTRATOR:REIMANN, CYNTHIAFACILITY TYPE:
850
ADDRESS:2162 MOUNTAIN BLVD STE 300TELEPHONE:
(510) 336-7082
CITY:OAKLANDSTATE: CAZIP CODE:
94611
CAPACITY: 53TOTAL ENROLLED CHILDREN: 53CENSUS: 18DATE:
01/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:TIME COMPLETED:
12:30 PM
NARRATIVE
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On 1/18/23 at 9:00am, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced on a case management inspection while at the center regarding another matter. Upon arrival LPA Fernandes observed Staff 1 (S1) in the classroom with 16 preschoolers and Staff 2 (S2) walking around the center preparing for the children to go outside. LPA spoke to S1 whom confirmed she was not a teacher and was only an assistant. S2 stated she had units but was not a teacher. A minute later another preschooler arrived making the total number of children in attendance 17. LPA did a walk through of the center and when returning to the classroom Andrea Manriquez-Collin (AMC) was in the classroom. AMC stated she was the head teacher for the classroom.

At 9:01am the center was out of ratio with 16 preschoolers and no qualified teachers or Directors on site. At 9:05AM there were 17 preschoolers with two teacher assistants. At 9:10am head teacher, AMC arrived to the center, soon after staff 4 arrived. The classroom was then split into two. After reviewing finger print clearances LPA Fernandes observed that AMC is not associated to the center. At 10:00am Director Cynthia Reimann arrived to the center and confirmed that AMC has been working at the center for two days.

One type A deficiency is being cited during todays inspection. The Director must provide a copy of this report to all parents of children currently enrolled, and the parents of newly enrolled children in the next 12 months. In addition, form LIC 9224 (Acknowledgment of Receipt of Licensing Reports) must be signed by each parent and placed in each child's file.

A copy of the LIC 9224 is being provided to the Director during the inspection.
Exit interview conducted. Report, and Appeal Rights provided to Director Cynthia Reimann.
Notice of Site visit must remain posted for 30 days
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2023
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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Document Has Been Signed on 01/18/2023 12:24 PM - It Cannot Be Edited


Created By: Catherine Fernandes On 01/18/2023 at 10:32 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ACADEMIA DE MI ABUELA
FACILITY NUMBER: 013420975

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/19/2023
Section Cited
CCR
101216.3(a)

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Teacher-Child Ratio There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance. This requirement has not been met as evidenced by:
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Center will come up with a schedule to reflect a qualified teacher is present at all times within ratio limits. Center will send the plan to CCLD by proof of correction date.
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Based on observations and interviews there were two teacher assistants caring for 17 preschoolers which is an immediate safety risk for children in care.
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Type B
01/23/2023
Section Cited
CCR101170(e)(2)

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Criminal Record Clearance All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 101170(f). This requirement has not
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The center will immediately contact the office and associate the staff member and send a statement to confirm the association.

There is a civil penalty of $200 that is assessed during todays inspection.
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been met as evidenced by: Based on record review and conformation from the Director Reimann staff member A. Manriquez- Collin has been at the center for two days, which is a safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mayla Mendoza
LICENSING EVALUATOR NAME:Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023


LIC809 (FAS) - (06/04)
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