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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423749
Report Date: 08/23/2023
Date Signed: 08/23/2023 03:13:19 PM

Document Has Been Signed on 08/23/2023 03:13 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:OMESCUELITA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
013423749
ADMINISTRATOR:AMY CHAPPELLEFACILITY TYPE:
850
ADDRESS:2162 MOUNTAIN BLVD SUITE 200TELEPHONE:
(650) 944-9655
CITY:OAKLANDSTATE: CAZIP CODE:
94611
CAPACITY: 84TOTAL ENROLLED CHILDREN: 84CENSUS: 0DATE:
08/23/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jesus BolivarTIME COMPLETED:
03:30 PM
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On 08/23/23 Licensing Program Analyst (LPA) Melissa Domantay arrived at the facility for an announced pre licensing inspection. LPA met with the Applicant, Jesus Bolivar. An application for a preschool license with toddler option was received for this facility. The facility will operate Monday-Friday 7:30AM to 6:00PM. The preschool has 6 areas and toddlers have 5 areas for children to utilize. LPA toured all areas, indoors and outdoors that will be used by and for children, to conduct a health and safety inspection, and the measurements are as follows:

PRESCHOOL CAPACITY:
INDOORS: 1927.27 square feet= 55 children
OUTDOORS: 1955.00 square feet= 26 children

TODDLER CAPACITY:
INDOORS: 2486.61 square feet = 71 children
OUTDOORS: 1615.15 square feet= 21 children

A fire clearance, with a total capacity of 48 preschoolers, ages 2 years to first grade entry, with toddler option, ages 18-36 months ,and school age, ages 4.9 to 13 years, total capacity 114 was received from the Oakland Fire Department, Per fire inspector Kirby inspection was approved 8/16/23. Fire Clearance states facility occupancy is not to exceed 60 children total while renovations are under way.

LPA observed that all areas have sufficient lighting, heating and ventilation for the safety and comfort of children and staff. The floors and surfaces are clean and in good condition. There is an ample supply of age appropriate activities, equipment, and furniture that is in good condition. There is a total of 4 toilets and 3 sinks available for children, and they are in sanitary and operational condition. There is a separate bathroom for staff. LPA notified Applicant and Director to submit waiver request for preschool and school age programs to share bathrooms with a schedule in place. LPA reminded Applicant and Director preschool children should have 100% supervision when utilizing the bathroom. The Director's office will be used for the isolation of sick children. The facility will provide snacks and lunch will be provided by families from home. Facility will provide water indoors and outdoors and children will utilize personal water bottles. The facility will utilize an electronic sign in/out system.

809-C for continuance
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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 2
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: OMESCUELITA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 013423749
VISIT DATE: 08/23/2023
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The facility is equipped with multiple 3A40BC fire extinguishers, pull down fire alarms, a centralized smoke and carbon monoxide detection system, working telephone, and first aid supplies. LPA did not observe any hazardous items, toxins, bodies of water or medication accessible to children during today's inspection.

LPA observed the outdoor play area is fully fenced and have amply supply of age appropriate activities, equipment, and furniture. There is cushioning for children, which includes turf. LPA observed ample amount of shade for children. LPA notified Applicant and Director a waiver must be submitted to request for outdoor play yard, no more than 26 children in the outdoor play yard at any given time and for preschool and school age programs to share play yard with a schedule in place. LPA reminded Applicant and Director there should be no commingling between preschool, toddler, and school age components.

Amy Chapelle is considered a qualified Director with current CPR/First Aid and mandated reporter training's completed.

If this facility plans to provide Incidental Medical Services – IMS. A 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.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. LPA reviewed responses and provided technical assistance including postings. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and 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 preschool with toddler option license for a capacity of 48 preschool children and 36 toddlers will be made part of the Preschool License and is approved as of 8/23/2023. Applicant and Director is reminded that the facility should not exceed 60 children between preschool, toddler, and school age components at any given time per fire clearance. There are no deficiencies being cited today. Exit interview conducted with Applicant, Jesus Bolivar.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
LIC809 (FAS) - (06/04)
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