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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700574
Report Date: 01/24/2024
Date Signed: 01/24/2024 12:29:55 PM

Document Has Been Signed on 01/24/2024 12:29 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:TOTS UNIVERSITY PRESCHOOLFACILITY NUMBER:
015700574
ADMINISTRATOR:BOGA, PRIYANKAFACILITY TYPE:
850
ADDRESS:7890 OXBOW LANETELEPHONE:
(225) 368-6002
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: 32DATE:
01/24/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Licensee, Priyanka BogaTIME COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Jyoti Saini arrived at the Facility unannounced for a ten-day visit. LPA observed S1 supervising nine (9) preschoolers in Room #1, AKA Giant Heart, and a volunteer
( S2) alone supervising nine (9) preschoolers in Room #2, AKA Smiles Heart. The director acknowledges that the individual is here to help the Facility. LPA notified the provider that the licensee may utilize volunteers, provided such volunteers are supervised and not included in the center's staffing plan. During the inspection, LPA also observed that the opening teacher (S1)does not have current CPR. LPA reminded the licensee that the opening and closing staff shall always maintain a current Pediatric First Aid/CPR certificate on file.

See 809-D for the TYPE A and TYPE B deficiencies cited on today's visit.

California Code of Regulations, {Title 22, Division 12, Chapter 1, Section 102370(d) is being cited on the attached LIC809-D. THE LICENSEE MUST POST ANY TYPE A DEFICIENCIES DURING TODAY'S VISIT WITH THE NOTICE, AND THE LICENSEE UNDERSTANDS THE NOTICE AND TYPE A DEFICIENCIES MUST REMAIN POSTED FOR THIRTY DAYS. REQUIREMENTS FOR THE AB 633 FACT SHEET AND A COPY OF THE ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) WERE DISCUSSED WITH THE PROVIDER. PROVIDER UNDERSTANDS THIS REQUIREMENT.

An exit interview was conducted with Licensee Priyanka Boga.

A notice of site visit was given and must remain posted for a period of 30 days.

The Facility's appeal rights were reviewed and given to the licensee, Priyanka Boga.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2024
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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Document Has Been Signed on 01/24/2024 12:29 PM - It Cannot Be Edited


Created By: Jyoti Saini On 01/24/2024 at 11:41 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: TOTS UNIVERSITY PRESCHOOL
FACILITY NUMBER: 015700574

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
01/25/2024
Section Cited
CCR
101216(c)

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101216(c) Personnel requirements: The licensee may utilize volunteers provided that such volunteers are supervised and are not included in the center's staffing plan.

This requirement is not met, as evidenced by:
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The licensee shall forward a written plan of correction indicating methods and procedures implemented to ensure the Facility maintains the teacher-child ratio at all times.
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Based on observation, interview, record review, the licensee did not comply with the section cited above. Upon arrival, LPA observed that a volunteer ( S2) was supervising nine preschoolers alone, which is an immediate risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Wynn Norona
LICENSING EVALUATOR NAME:Jyoti Saini
LICENSING EVALUATOR SIGNATURE:
DATE: 01/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/24/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/24/2024 12:29 PM - It Cannot Be Edited


Created By: Jyoti Saini On 01/24/2024 at 11:51 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: TOTS UNIVERSITY PRESCHOOL
FACILITY NUMBER: 015700574

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/01/2024
Section Cited
CCR
102416(c)

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(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
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The director shall ensure the opening and closing staff has a current Pediatric First Aid/CPR certificate. The Facility shall submit the proof to the LPA by the due date.
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Based on observation, interview, and record review, the licensee did not comply with the section cited above. The opening teacher (S1) did not have current CPR, which poses a potential health, safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Wynn Norona
LICENSING EVALUATOR NAME:Jyoti Saini
LICENSING EVALUATOR SIGNATURE:
DATE: 01/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/24/2024


LIC809 (FAS) - (06/04)
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