013423750-8-23-2023-02-CC-MDOY-CUYU5V-20230823151721

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423750
Report Date: 08/23/2023
Date Signed: 08/23/2023 03:18:16 PM

Document Has Been Signed on 08/23/2023 03:18 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 CENTER		FACILITY NUMBER:	013423750
ADMINISTRATOR:	AMY CHAPPELLE		FACILITY TYPE:	840
ADDRESS:	2162 MOUNTAIN BLVD SUITE 200		TELEPHONE:	(650) 944-9655
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94611
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 0	DATE:	08/23/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Jesus Bolivar		TIME COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	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 school age license was received for this facility. The facility will operate Monday-Friday 3:30PM to 6:00PM. The school age has 3 indoor 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: INDOORS: 1069.99 square feet = 30 children OUTDOORS: 1955.00 square feet= 26 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 the school-age classroom, classrooms. has sufficient lighting and appears to be clean and in good condition. LPA observed an ample supply of age appropriate activities, equipment and furniture. The school-age program operates in 3 designated classrooms. The facility has 3 toilets and 2 sinks for school-age children to utilize. 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 school age children should have privacy when utilizing the bathroom. There is a separate staff bathroom on school grounds for staff to utilize. The building has multiple fully charged fire extinguishers, combination carbon monoxide, and working fire alarm and first aid supplies. There is a working telephone at the center. LPA did not observe any hazardous items that would be accessible to children. Facility will provide water for children, with water still accessible to children inside and outside. Children will utilize personal water bottles. Facility will provide PM snacks. Facility will utilize electronic sign in/out. Continuance on 809-C

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)

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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: OMESCUELITA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 013423750
	VISIT DATE: 08/23/2023

NARRATIVE

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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 out door play yard at any given time and for prescshool 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.

The isolation area will be the Directors office for sick children.

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. LPAs 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 School-Age license for a capacity of 30 children will be granted today, 8/23/23. 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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