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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423771
Report Date: 02/10/2025
Date Signed: 02/10/2025 01:43:43 PM

Document Has Been Signed on 02/10/2025 01:43 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ALAMEDA HEAD START - SUE MATHESON CENTERFACILITY NUMBER:
013423771
ADMINISTRATOR/
DIRECTOR:		KYM AKINTOMIDEFACILITY TYPE:
860
ADDRESS:670 WEST MIDWAYTELEPHONE:
(510) 521-3443
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 31DATE:
02/10/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Kym Akintomide and Julie GiesslerTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On Monday, February 10, 2025 Centralized Application Bureau (CAB) Licensing Program Analysts (LPAs) M. Domantay and Diana Campos met with Director Kym Akintomide upon arrival and Child development Services Manager Julie Giessler for the purpose of a Pre licensing inspection. Applicant requests a single licensed child care center and adding a Toddler Program to the existing Preschool and infant license to serve 20 Preschool children from ages 2 years to first grade entry, 8 infants ages 0-24 months, and 16 toddlers ages 18-36 months. The program will operate Monday through Friday 8:00a.m to 3:00p.m. The fire clearance was granted and approved on 12/13/2024, from the Alameda Fire Department. The facility does provide food for children.

LPA informed Julie that the facility will be converted to a single child care center license under facility number 013423771, therefore LPA will be closing the current preschool facility number 013417425 and infant facility number 013420540.

LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

INDOOR ACTIVITY SPACE:
There are 2 Toddler indoor areas: Classroom #2 and #3. LPAs observed sufficient amount of equipment, toys, tables, mats, and chairs during today's inspection. LPAs observed a changing tables is in hands reach of a sink in each classroom. Per Director a first aid kit is available in each toddler classroom. Medications will be stored on the top storage in a backpack in the Toddler Classrooms. LPAs observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. LPAs observed a carbon monoxide detector in the facility in Toddler Classroom #3. Per Applicant facility will utilize manual sign-in/sign-out system.

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SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE: DATE: 02/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2025
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ALAMEDA HEAD START - SUE MATHESON CENTER
FACILITY NUMBER: 013423771
VISIT DATE: 02/10/2025
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LPA measured the Toddler classrooms. The total classroom space contains a total of 1331.95 square feet, which will accommodate Applicant's request for 16 Toddler children. There is 4 toilets and 4 sinks for the children, and a separate private restroom for the staff is located in the toddler classrooms.. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the Family Advocate office and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is 1 toddler outdoor area at the facility, the Toddler outdoor play yard. The outdoor play area is fenced with metal wired fencing with paneling that is at least four feet tall. There is no play structure in the toddler play yard. Play yard has rubber mating, tan bark, and turf as cushioning to cushion a child's fall. LPAs observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. LPAs reminded Applicant to ensure to empty all water tables when not in use. There is sufficient shading areas provided by trees and canopies in the play yard. LPAs observed swings and a tire swing in the toddler play yard. Per Applicant Julie, swings and tire swing will be removed and Julie will send LPA photos when items are removed from the toddler play yard.

LPAs measured the Toddler outdoor play yard. The total toddler outdoor play yard space contains a total of 3,721.84 square feet, which will accommodate Applicant's request for 16 Toddler children.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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

LPA discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

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SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ALAMEDA HEAD START - SUE MATHESON CENTER
FACILITY NUMBER: 013423771
VISIT DATE: 02/10/2025
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Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with Child development Services Manager Julie Giessler

The following items are required before a license will be issued:

1. Regional Manager (RM) final file review.


2. Applicant must submit revised, updated LIC200A.
3. Applicant must submit photos of Toddler yard with swings and tire swing removed.

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SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2025
LIC809 (FAS) - (06/04)
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