013423782-9-9-2024-02-CC-MDOY-D8XTKR-20240909144823

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423782
Report Date: 09/09/2024
Date Signed: 09/09/2024 02:48:56 PM

Document Has Been Signed on 09/09/2024 02:48 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:	BERKELEY ROSE WALDORF SCHOOL		FACILITY NUMBER:	013423782
ADMINISTRATOR/ DIRECTOR:	MEGAN COLEMAN		FACILITY TYPE:	860
ADDRESS:	215 RIDGEWAY AVE		TELEPHONE:	(510) 859-7679
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94611
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	09/09/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Megan Coleman		TIME VISIT/ INSPECTION COMPLETED:	01:00 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	Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) M. Domantay met with Applicant Megan Coleman for the purpose of a change of location inspection. Applicant requests a single licensed child care center for a preschool program ages 2 years to first grade entry, license to serve a total of 24 children. The program will operate Monday through Friday from 8:30 a.m. to 5:30 p.m. The fire clearance was granted on 8/28/2024 from the Oakland Fire Department. The facility will not be providing food, snacks and lunch will be provided by families from home. 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. LPA informed Megan that the facility will be converted to a single child care center license under facility number 013423782, therefore LPA will be closing the current preschool facility number 013423057. INDOOR ACTIVITY SPACE: There are 2 indoor areas for the preschool program, classroom 1 (marigold Room) and classroom 2 (rosebud Room). LPA observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping mats. LPA observed a first aid it in classroom 1. Per Applicant Megan there is a first aid kit in each classroom and in the office. Medications will be stored in a locked in the office. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. LPA observed a functional carbon monoxide detector in classroom 1. LPA observed a manual sign-in/sign-out system. LPA measured all classrooms for the preschool program. The total classroom space for the preschool classroom contains a total of 848.87 square feet, which will accommodate Applicant's request for 24 preschool children. There is 2 toilets and 4 sinks for the children, and a separate private restroom for the staff is located within the facility. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Page 1

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2024

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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BERKELEY ROSE WALDORF SCHOOL	FACILITY NUMBER: 013423782
	VISIT DATE: 09/09/2024

NARRATIVE

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Children who become ill during the day will be isolated in the Director's office and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
LPA measured all outdoor areas for Preschool program. The outdoor play area is fenced with a wooden fence that is at least four feet tall. LPA observed a sufficient amount of equipment and toys. Per Applicant, will set up additional furniture and equipment in play yard 4 and send photos to LPA. There is a sandbox in play yard 2 that was observed to be maintained and free of debris. There is no play structure present in the outdoor play yard areas. There are no bodies of water on the premises. LPA reminded Applicant Megan that all water tables and buckets should be emptied after each use. There is sufficient shading provided by trees and canopies for the preschool play areas.

The total outdoor space for the Preschool program contains a total of 2,179.81 square feet, which will accommodate Applicant's request for 24 children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

LPA notified Applicant will need to submit a request for a waiver for the bathrooms to be shared between the elementary school and preschool program.

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.

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. Page 2

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2024

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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BERKELEY ROSE WALDORF SCHOOL	FACILITY NUMBER: 013423782
	VISIT DATE: 09/09/2024

NARRATIVE

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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.

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

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 the Applicant, Megan Coleman.

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

1. Licensing Program Manager (LPM) final file review.

2. Waiver Request for Preschool program and elementary school to share bathroom on a set schedule.

3. Applicant must submit photo of lock on door in play yard 4 area 1 to LPA.

4. Applicant must submit photos of additional equipment and furniture in play yard 4 areas to LPA.

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SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2024

LIC809 (FAS) - (06/04)

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