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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700537
Report Date: 07/07/2026
Date Signed: 07/07/2026 12:17:51 PM

Document Has Been Signed on 07/07/2026 12:17 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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:CAPE SUNSET SITEFACILITY NUMBER:
015700537
ADMINISTRATOR/
DIRECTOR:
MOHAMED, JAMILAFACILITY TYPE:
850
ADDRESS:22100 PRINCETON STREETTELEPHONE:
(925) 443-3434
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 20DATE:
07/07/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Fabiola GarciaTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
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On July 7, 2026, at approximately 8:35 AM, Licensing Program Analyst (LPA) Elimika Woods met with Facility Representative Fabiola Garcia to conduct an unannounced annual random inspection. The facility is licensed for a capacity of thirty-six (36) preschool/Toddler age children and operates out of two (2) classrooms. At the time of the inspection, twenty (20) children were present and being supervised by five (5) fingerprint cleared staff members. LPA toured the facility with the Facility Representative, inspecting both the indoor and outdoor areas to conduct an health and safety inspection.

All individuals subject to criminal record review have obtained a criminal record clearance or exemption and are properly associated with the facility. LPA conducted a census of the children in care and verified that the attendance matched the twenty (20) electronic signatures recorded in the facility's electronic sign-in system.

At approximately 9:00 AM, LPA reviewed five (5) children's files. Each file contained the required Identification and Emergency Information, Medical Consent, and Parent's Rights forms. LPA also reviewed three (3) staff files at approximately 9:25 AM. All staff files contained the required Health Screening Report and Employee Rights forms. At least one staff member with current pediatric CPR and First Aid certification was present during the inspection.

LPA tested the facility's dual smoke and carbon monoxide detector and verified that it was functioning properly. The facility is equipped with a working telephone, first aid kits, emergency backpacks, and multiple fully charged 3A40BC fire extinguishers that meet the standards established by the State Fire Marshal. Disaster drills are being conducted at least once every six months with the most recent conducted on June 11, 2026.



At approximately 9:45 AM, LPA inspected both (2) classrooms and verified that the required teacher-to-child ratios were being maintained. The classrooms were thoughtfully arranged to encourage children's exploration and participation in a variety of learning activities. An adequate supply of age-appropriate educational materials and toys was available for children's use. The classrooms were clean and orderly, with furniture appropriately sized for preschool-age children and toddlers. All play equipment was observed to be in good condition and suitable for the children's developmental ages. Each child had an individually designated storage space for personal belongings. The facility's designated isolation area for ill children is located in the library area, which is separated from the children receiving care. All required licensing documents were posted in a location that is readily visible and accessible to the public.
See 809-C.
NAME OF LICENSING PROGRAM MANAGER: Chandra Charles
NAME OF LICENSING PROGRAM ANALYST: Elimika Woods
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAPE SUNSET SITE
FACILITY NUMBER: 015700537
VISIT DATE: 07/07/2026
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

The facility provides breakfast, lunch, and snacks to children in care, and a weekly menu is posted for parents' review. LPA inspected the food preparation and refrigerator areas and observed them to be clean, sanitary, and free of debris or evidence of rodents. The facility serves low-fat milk to children. Food was observed to be stored in a manner that protects it from contamination, and staff reported that any contaminated food is discarded immediately. Perishable foods and beverages requiring refrigeration were properly stored. Trash containers used for solid waste were equipped with tight-fitting lids and were maintained in good condition.

LPA inspected the outdoor play areas and observed that they were fully enclosed by appropriate fencing, maintained in a safe condition, and free of hazards. The toddler playground is separated from the preschool playground to ensure age-appropriate play. The toddler play structure was securely anchored and surrounded by resilient cushioning material intended to reduce the impact of falls. All outdoor play equipment was appropriate for the children's ages, well maintained, and in good repair.

The preschool playground was also inspected and found to be fully enclosed and free of hazardous conditions. The outdoor environment included a variety of developmentally appropriate equipment and activity areas, including water tables, tricycles, gardening planters, tables and chairs, benches, a sandbox, a climbing structure with slides, resilient surfacing beneath the equipment, basketball hoops, an easel, and a dramatic play kitchen with a sink. Shade was provided by a canopy, awnings, and mature trees to protect children from direct sunlight during outdoor activities. Storage containers and outdoor sheds were locked and inaccessible to children.

LPA inspected the children's restroom and was informed by the Facility Representative that staff utilize a designated restroom stall located at the far left end of the children's restroom, which is clearly marked for staff use only. The Facility Representative stated that the stall is locked whenever it is in use by staff, preventing children from entering. All sinks, toilets, and faucets were observed to be clean, safe, and in good working order. The fixtures were appropriately sized and accessible to the children, and soap and paper towels were readily available to support proper handwashing practices.

California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

See 809-C.

NAME OF LICENSING PROGRAM MANAGER: Chandra Charles
NAME OF LICENSING PROGRAM ANALYST: Elimika Woods
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026
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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAPE SUNSET SITE
FACILITY NUMBER: 015700537
VISIT DATE: 07/07/2026
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LPA discussed the safe sleep regulations with facility representative 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. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

The facility representative was reminded that all adults 18 and over, 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.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Fabiola Garcia.

NAME OF LICENSING PROGRAM MANAGER: Chandra Charles
NAME OF LICENSING PROGRAM ANALYST: Elimika Woods
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026
LIC809 (FAS) - (06/04)
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