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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700556
Report Date: 01/08/2025
Date Signed: 01/08/2025 03:41:26 PM

Document Has Been Signed on 01/08/2025 03:41 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:YMCA OF THE EAST BAY-SIAC EARLY LEARNING CENTERFACILITY NUMBER:
015700556
ADMINISTRATOR/
DIRECTOR:
LILLY, DONUELLFACILITY TYPE:
830
ADDRESS:27211 TYRRELL AVENUETELEPHONE:
(510) 640-5836
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 46DATE:
01/08/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Stephanie PittmanTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On January 8, 2025 at 11:00 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced Annual Random Inspection and met with the facility representative, Stephanie Pittman. LPA disclosed the purpose of the inspection and was granted entry into the facility by the facility representative. There were 46 infant children present during this inspection and 11 additional staff members. The infant program is located on the campus of SIAC Early Learning Center. The program is currently utilizing four infant classrooms located in rooms #5, #7, #9, and #11 A/B and one toddler classroom located in room #2. The hours of operation are Monday through Friday from 7:30AM - 5:00PM. This is a TITLE V Facility.

LPA checked the facility RECORDS and they show all individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. LPA conducted a census of the children and the census matches the children signed in on the electronic system. LPA reviewed four (4) children's files and two (2) staff files around 11:45 AM. All staff files have required Health Screening, and Employee Rights, and all children files contains Personal Rights, Parent's Rights, and Identification & Emergency Information. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed, and certificates were reviewed.

The four (4) classrooms were inspected around 11:30 AM and teacher child ratio was observed. There are adequate play and learning materials available. The floors are well maintained and the furniture is the correct size for infant children. The classrooms equipment is in good repair and the room temperature is adequate for children in care. There is proper individual storage space for each child and the cubbies have their names and photos posted on the shelves. The isolation area for sick children is the front director's office, away from other children in care.

LPA tested the center's smoke and carbon monoxide detectors and found them to be functioning properly. The center has a working telephone, first aid kits, and multiple fully charged 3A40BC fire extinguishers which meets standards established by the State Fire Marshal hanging on the wall in each classroom. Disaster drills are being conducted at least once every 6 months and the last one conducted was on 01/03/2025. All required documents are posted in a public accessible area.

See 809-C.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2025
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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YMCA OF THE EAST BAY-SIAC EARLY LEARNING CENTER
FACILITY NUMBER: 015700556
VISIT DATE: 01/08/2025
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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 PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-carecenters/.

LPA reminded the facility representative that a refrigerator shall be used to store any medications that requires refrigeration. The center is equipped with fully stocked first aid kits that are available in the classrooms.

This facility provides breakfast, lunch, and snacks for the children. There are weekly menus posted at the facility. Food is protected from contamination and, per staff, contaminated food is discarded immediately. Food/beverages capable of rapid spoiling are properly stored. All storage containers for solid waste have tight fitting covers that are in good repair.

The outdoor area is fully fenced and free of hazards. There are canopies that provide shade to children while at play and the staff brings the children’s water bottles and cups to keep the children hydrated. The play equipment is age appropriate and in good repair. There are sheds with locks to prevent children from getting the play equipment or hiding in the unit.

The staff's bathroom is separate from the children's bathroom and all of the sinks and faucets are in safe and sanitary operating condition. LPA tested all toilets and sinks in the infant classroom to make sure that they were operating correctly and they were. There are changing table in arms reach of the faucets in each classroom and extra clothes and supplies for the children. The children can reach the sinks and toilets and the paper towels and soap are available to the children.



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. LPA reminded the facility representative that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

See 809-C

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YMCA OF THE EAST BAY-SIAC EARLY LEARNING CENTER
FACILITY NUMBER: 015700556
VISIT DATE: 01/08/2025
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Lead Testing – Child Care Centers (CCC) CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-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.

The facility representative was informed of the MyChildCarePlan.org website; 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.

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 Stephanie Pittman.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
LIC809 (FAS) - (06/04)
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