073406858-4-30-2024-02-CC-BCRS-D4TQTT-20240430122741

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073406858
Report Date: 04/30/2024
Date Signed: 04/30/2024 12:27:51 PM

Document Has Been Signed on 04/30/2024 12:27 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:	WCCUSD STATE PRESCHOOL - FORD		FACILITY NUMBER:	073406858
ADMINISTRATOR/ DIRECTOR:	LLANES, EMILIA		FACILITY TYPE:	850
ADDRESS:	2711 MARICOPA AVENUE		TELEPHONE:	(510) 307-4593
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94804
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 21	CENSUS: 21	DATE:	04/30/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Tamika Ford/Claudia Hernandez		TIME VISIT/ INSPECTION COMPLETED:	12:50 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 04/30/2024 at 9:00 AM Licensing Program Analyst (LPA), B. Crass conducted an unannounced Annual/Random inspection. LPA met with the Head Teacher, Tamika Ford. Claudia Hernandez, Typist Clerk, arrived with the files shortly afterwards. This is a preschool age program with an AM and a PM class. This facility is licensed for 24 children and operates Monday – Friday from 8:30AM – 11:30AM and 12:15PM - 3:15PM. Per the Children's Roster there are 21 children enrolled.

LPA B. Crass toured the facility for a health and safety inspection. LPA observed 21 children with 3 staff. Teacher-child ratios were observed to be in accordance with Title 5 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. Staff names were recorded.

LPA observed the facility to be clean, safe, sanitary and in good repair. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free.

Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. All storage containers for solid waste, including moveable bins are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The licensee takes measures to keep the facility free of flies, other insects and rodents.

Outdoor play area was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards. LPA did not observe any bodies of water during this visit. Claudia Hernandez states there are no weapons or firearms on the premises.

(Report continues, See 809-C).

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Brittany Crass
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

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: WCCUSD STATE PRESCHOOL - FORD	FACILITY NUMBER: 073406858
	VISIT DATE: 04/30/2024

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
26
27
28
29
30
31
32

Sign in and out sheets are done electronically and were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Children and staff files were reviewed. All staff members had CPR certificates.

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 childcare 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). The facility has not completed the required LEAD testing (See 809-D for deficiency cited today).

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated 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 are available at: https://www.ada.gov/resources/child-care-centers/.

Licensee 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.

Licensee 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.

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

Exit interview conducted, appeal rights were given, and report was reviewed with Claudia Hernandez

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Brittany Crass
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

Document Has Been Signed on 04/30/2024 12:27 PM - It Cannot Be Edited

Created By: Brittany Crass On 04/30/2024 at 12:16 PM

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: WCCUSD STATE PRESCHOOL - FORD	FACILITY NUMBER: 073406858
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above by not completing LEAD testing, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/30/2024
	Plan of Correction
1 2 3 4	By 5/30/2024, the licensee will conduct LEAD testing and will email LPA a copy of the receipt.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Mayla Mendoza

LICENSING EVALUATOR NAME:

Brittany Crass

LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4