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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423731
Report Date: 12/01/2022
Date Signed: 12/01/2022 12:07:15 PM

Document Has Been Signed on 12/01/2022 12:07 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:WILMA CHAN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
013423731
ADMINISTRATOR:LUIS ARENASFACILITY TYPE:
830
ADDRESS:7920 PLYMOUTH STREETTELEPHONE:
(510) 535-6949
CITY:OAKLANDSTATE: CAZIP CODE:
94621
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 0DATE:
12/01/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Xochitl Garcia VillafanaTIME COMPLETED:
12:30 PM
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Licensing Program Analysts (LPAs) Melissa Domantay and Melissa Guirit conducted a Prelicensing inspection today, December 1, 2022 for the initial application for a infant center with toddler option that was submitted by the applicant. LPAs met with Operations Manager, Xochitl Garcia Villafana and toured all areas of the facility for a health and safety inspection. The center has also applied for a preschool program on-site (license #13423732). The infant and toddler option program will operate in 1 classroom, Room 2, in Room 2(A) for Infant program and Room 2(B) for toddler option. The hours of operation are Monday through Friday from 7:30am to 5:30pm. The measurements are as follows:

INDOORS: 1,399.98 square feet = 40 children
OUTDOORS : 2,421.89 square feet = 32 children
A fire clearance, with a total capacity of 20 preschoolers, ages 2 years to first grade entry and 8 infants, ages 0-24 months, 8 toddlers, ages 18-36 months was received from the Oakland Fire Department.

LPAs observed that the infant classrooms has sufficient lighting and appears to be clean and in good condition. LPAs observed an ample supply of age appropriate activities, equipment and furniture. The classroom has 3 sinks and 1 toilet in the infant/toddler classroom. The infant program will not serve crib-aged infants. The diaper changing counters are within arms reach of a sink. The classroom has a fully charged 3A40BC fire extinguisher, working fire alarm and carbon monoxide detector, and first aid supplies. There is a working telephone at the center. LPAs did not observe any hazardous items that would be accessible to children. Facility will provide drinking water for children indoors and outdoors. Facility will provide breakfast, lunch, and afternoon snack for children. There is a kitchen in the facility, off limits to children. The staff break room will be used for ill children as the isolation area.

See 809-C for continuance.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: WILMA CHAN CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 013423731
VISIT DATE: 12/01/2022
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LPAs observed the outdoor play area, they are fully fenced and have amply supply of age appropriate activities, equipment, and furniture. LPAs observed ample amount of shade for children. Play yard will be shared between infants and toddlers. Xochitl has provided a play yard schedule for infant and toddler program to make sure infant and toddlers do not commingle.

Xochitl is reminded that if facility plans to provide Incidental Medical Services a plan should be provided. – IMS. A Plan of Operation that includes IMS has been 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.

Joy Ouellette is considered a fully-qualified Preschool Director with a Child Development Program Director Permit that is valid 6/9/2020-7/1/2025, Pediatric CPR/First Aid that is valid until 3/19/2024, and mandated report certificate.

Mandated reporter, appeal rights, civil penalties, unusual incident reporting, fingerprint requirements, and COVID protocols were discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and checking Provider Information Notices (PINs). The director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

A license for 8 infants and 8 toddler children will be effective today 12/1/22. An exit interview was conducted, and a copy of the report was provided to Operations Manager Xochitl Garcia Villafana
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
LIC809 (FAS) - (06/04)
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