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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423040
Report Date: 12/10/2021
Date Signed: 03/09/2022 11:01:21 AM

Document Has Been Signed on 03/09/2022 11:01 AM - 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:YMCA EASTLAKE CENTERFACILITY NUMBER:
013423040
ADMINISTRATOR:MARTA PEREIRAFACILITY TYPE:
850
ADDRESS:1612-45TH AVETELEPHONE:
(510) 370-2966
CITY:OAKLANDSTATE: CAZIP CODE:
94601
CAPACITY: 60TOTAL ENROLLED CHILDREN: 35CENSUS: 15DATE:
12/10/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:44 AM
MET WITH:Lovette TrammelTIME COMPLETED:
11:30 AM
NARRATIVE
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On 12/10/2021 at 9:30am Licensing Program Analyst (LPA) Diana Campos arrived at the for the purpose of conducting a Case Management inspection to follow up on the self reported incident that occurred on 09/27/2021. LPA met with Center Director Lovette Trammel who guided LPA on a tour of the facility.
During the investigation LPA interviewed staff, and obtained copies of relevant documents. Based on inspection, interviews and documents received, it was reported that on 09/27/2021 between 9:30am-10:30am during free play, a child got slime into another child's hair. Teacher attempted to remove the slime from child's hair but could not and cut child's hair to get it out. On 9/30/2021 the child's parent brought the matter to the attention of the Center Director. Center Director was unaware of situation. An investigation was conducted by the Director while parent remained on site. Director then communicated to parent that she would bring the matter up to the attention of her supervisors and Teacher was placed on administrative leave until further notice. Per a meeting held by YMCA supervisors, staff and the union, it was determined that a violation of children's personal right's did occur. Teacher was terminated on 10/05/2021. All staff received training on children's personal rights. The child returned to the facility then was dis-enrolled by parent.

Please see LIC809D for the attached type B violation being cited today.


Exit interview conducted with Center Director Lovette Trammel.
Notice of Site visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 12/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2021
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 03/09/2022 11:01 AM - It Cannot Be Edited


Created By: Diana Campos On 03/09/2022 at 09:33 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: YMCA EASTLAKE CENTER
FACILITY NUMBER: 013423040

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/17/2021
Section Cited
CCR
101223(a)(1)(2)(3)

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(a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement was not met as evidenced by:

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Teacher was placed on administrative leave, then terminated on 10/05/2021. All staff received training on children's personal rights on 10/04/2021.
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While attempting to remove slime from day care child's hair, a facility staff cut child's hair without parent's prior consultation or consent.
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Going forward staff has been advised to notify director and parents prior to making such decisions regarding day care children. This deficiency has therefore been corrected.

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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:Sherelle Johnson
LICENSING EVALUATOR NAME:Diana Campos
LICENSING EVALUATOR SIGNATURE:
DATE: 12/10/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/10/2021


LIC809 (FAS) - (06/04)
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