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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423773
Report Date: 07/31/2024
Date Signed: 07/31/2024 05:32:23 PM

Document Has Been Signed on 07/31/2024 05:32 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:YMCA OF THE EAST BAY - WEST YFACILITY NUMBER:
013423773
ADMINISTRATOR/
DIRECTOR:		CROSS-BROOKS, GLORIAFACILITY TYPE:
860
ADDRESS:2009 10TH STREETTELEPHONE:
(510) 848-9092
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 32DATE:
07/31/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Carla CooperTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Director of Operations Carla Cooper and Center Director Gloria Cross-Brooks for the purpose of a pre-licensing inspection. Licensee is requesting an infant component for 15 infants ages 0-24 months, a toddler component for 16 toddlers ages 18-36 months, and a preschool component for 48 children from age two years to entry into kindergarten for a total capacity of 79. The program currently operates Monday through Friday from 7:00 a.m. to 5:30 p.m. The fire clearance was granted and received on 7/9/2024. The facility currently provides breakfast, lunch, and afternoon snack.

LPA informed Director that the facility will be converted to a single child care center license under one facility number 013423773, therefore LPA will be closing the current infant and preschool facility numbers 013417823/010206120.

LPA reviewed with Director the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. LPA discussed the safe sleep regulations with the Regional Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

INDOOR ACTIVITY SPACE:
There is one infant classroom located in Room #1, one toddler classroom located in Room #2, and two preschool classrooms located in Rooms #3 and #4. LPA observed a sufficient amount of equipment, toys, tables, chairs, and cubbies for all classrooms. LPA observed a crib area dividing the indoor activity space using a four-foot-tall gate with six cribs available in Room #1.

Report continues LIC809-C page 2.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2024
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 4
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: YMCA OF THE EAST BAY - WEST Y
FACILITY NUMBER: 013423773
VISIT DATE: 07/31/2024
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Page 2.

LPA observed napping cots for the toddlers and preschool children. There is a first aid kit in each of the classrooms. Medications will be stored in each classroom in a locked box. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. LPA observed water pitchers in each classroom. LPA observed a functional carbon monoxide detector in each classroom. LPA observed an electronic sign-in/sign-out system.

LPA measured the infant classroom (Room #1). The infant classroom contains a total of 551 square feet which will accommodate Licensee’s request for 15 infants. LPA measured the toddler classroom (Room #2). The toddler classroom space contains a total of 991 square feet which will accommodate Licensee’s request for 16 toddlers. LPA measured the preschool classrooms (Rooms #3 and #4). The preschool classroom spaces contain a total of 1,869 square feet which will accommodate Licensee’s request for 48 preschool children. There are two sinks located in Room #1. LPA observed a diaper changing table within arm’s reach of the sink. There are three sinks in Room #2 and two sinks and three toilets between Room #2 and Room #3. There are two sinks located in Room #3 and two sinks located in Room #4. There is an additional children's bathroom located down the hall next to Room #1 with six sinks and five toilets. There is a private restroom for staff located in the hallway. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There are two outdoor areas on the property (Infant Yard and Toddler/Preschool Yard). Licensee has requested a Shared Outdoor Space Waiver for the Toddler/Preschool Yard. The outdoor play area is fenced with a chain link fence and brick wall that is at least four feet tall and separates the infant yard from the toddler/preschool yard. LPA observed a sufficient amount of equipment and toys. There is one play structure located in the Toddler/Preschool Yard. LPA observed a safety label approved for ages 2 to 5 years old. Licensee understands that children under the age of 2 years old cannot utilize the play structure at any time. There are no bodies of water on the premises. There are shaded areas supplied by a tree and canopies.

Report continues on LIC809-C page 3.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: YMCA OF THE EAST BAY - WEST Y
FACILITY NUMBER: 013423773
VISIT DATE: 07/31/2024
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LPA measured the Infant Yard. The infant outdoor activity spaces contain a total of 841 square feet which will only accommodate 11 infants. LPA observed a current Insufficient Outdoor Space Waiver on file. LPA measured the Toddler/Preschool Yard. The toddler/preschool outdoor activity space contains a total of 3,631 square feet which will accommodate Licensee’s request for 16 toddlers and 48 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

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 Director 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.

Director 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.

Report continues on LIC809-C page 4.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: YMCA OF THE EAST BAY - WEST Y
FACILITY NUMBER: 013423773
VISIT DATE: 07/31/2024
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Director 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 Director of Operations Carla Cooper.

The following item is required before a license will be issued:
1. Pending approval of Shared Outdoor Space Waiver.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4