015700575-5-12-2023-52-CC-EWOS-CRRT5D-20230512142522

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700575
Report Date: 05/12/2023
Date Signed: 05/12/2023 02:25:36 PM

Document Has Been Signed on 05/12/2023 02:25 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:	HUSD - EAST AVENUE PRESCHOOL		FACILITY NUMBER:	015700575
ADMINISTRATOR:	RUIZ, MARIA		FACILITY TYPE:	850
ADDRESS:	2424 EAST AVENUE		TELEPHONE:	(510) 723-3815
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 7	DATE:	05/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Maria Ruiz		TIME COMPLETED:	03:00 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	On May 12, 2023 at 11:30 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced 1 Year Required Inspection and met with the facility representative, Maria Ruiz. LPA disclosed the purpose of the inspection and was granted entry into the facility by the facility representative. There were seven (7) children present during this inspection and one (1) additional staff member. The facility is located on the campus of East Avenue Elementary School in Room 26. This is a TITLE V facility and the hours of operation are Monday-Friday 8:30 AM-11:30 AM for the morning session and 12:30-3:30 PM for the afternoon session. The facility was toured inside and outside for a health and safety inspection. LPA checked the facility RECORDS and they individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Staff files are maintained and stored in the Hayward School Districts Human Resource Office, and all licensing requirements for personnel are met as a condition of employment with the school district. LPA reviewed three (3) children's files around 12:45 PM. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. The one (1) classroom was inspected around 11:45 PM and teacher child ratio was observed. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is in the main office, away from other children in care. The center has a wired smoke detectors, a carbon monoxide detector, working telephone, and a fully charged 3A40BC fire extinguisher, which meets standards established by the State Fire Marshal. Disaster drills are being conducted at least once every 6 months in conjunction with the Hayward Unified School District schedule. 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: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

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: HUSD - EAST AVENUE PRESCHOOL	FACILITY NUMBER: 015700575
	VISIT DATE: 05/12/2023

NARRATIVE

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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

Incidental Medical Services (IMS) is being provided at this facility. LPA inspected the medication, which is stored in a safe place that is inaccessible to children in care. Each of the medications has an unaltered label with the child’s name and date of issuance. 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 kit that is available in the classroom.

This facility provides breakfast, and lunch for the children. There are weekly menus posted at the facility. LPA observed an area where they have a refrigerator this area is clean and free of evidence of rodents. Food is protected from contamination and, per staff, contaminated food is discarded immediately. The facility serves low-fat milk to children in care. Food/beverages capable of rapid spoiling are properly stored. Pesticides and other similar toxic substances are not stored in cabinets that contains food. All storage containers for solid waste have tight fitting covers that are in good repair.

The outdoor area has a play structure with a slide that has cushioning to absorb children's falls that is anchored. The playground area is fully fenced. The building has an awning that provides shade to children while at play. 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.

The children's bathroom is located inside the classroom and all of the sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets and the paper towels and soap are available to the children. The staff's bathroom is separate from the children's bathroom.

See 809-C

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: HUSD - EAST AVENUE PRESCHOOL	FACILITY NUMBER: 015700575
	VISIT DATE: 05/12/2023

NARRATIVE

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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. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

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.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/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, Maria Ruiz.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

LIC809 (FAS) - (06/04)

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