073408944-5-14-2024-02-CC-SBLE-D59UQ3-20240514154627

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408944
Report Date: 05/14/2024
Date Signed: 05/14/2024 03:46:36 PM

Document Has Been Signed on 05/14/2024 03:46 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:	YMCA OF THE EAST BAY - LONE TREE ELC		FACILITY NUMBER:	073408944
ADMINISTRATOR:	SHAMAICA WALKER		FACILITY TYPE:	850
ADDRESS:	1931 MOKELUMNE DRIVE		TELEPHONE:	(925) 644-6116
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94531
CAPACITY:	57	CENSUS: 38	DATE:	05/14/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Shamaica Walker		TIME COMPLETED:	04:00 PM

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On 05/14/2024 at 12:00 PM Licensing Program Analyst (LPA), S. Blue arrived at YMCA of the East Bay Lone tree to conduct an unannounced required inspection. LPA met with designated facility director, Shamaica Walker. This is a preschool age program with toddler component, licensed for 57 children which operates Monday – Friday from 7 AM – 5:30 PM. There were 38 children present today and Per the director and roaster observed there are 43 children enrolled.

LPAs began facility tour with director. All areas identified on the facility sketch were inspected. LPA observed 38 children with 9 staff members present. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times.

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. At this time, the office is used as an isolation area for sick children. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted.

Food is provided at the facility. LPA observed where food is stored and it is stored appropriately. There is drinking water available in all indoor classrooms and individual water cups are taken outdoors. All storage containers for solid waste, including moveable bins, have tight fitting covers on and 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 director takes measures to keep the facility free of flies, other insects and rodents.

REPORT CONTINUED ON LIC 809C PAGE(2)*****

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sikia Blue	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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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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: YMCA OF THE EAST BAY - LONE TREE ELC	FACILITY NUMBER: 073408944
	VISIT DATE: 05/14/2024

NARRATIVE

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PAGE (2)*****

Outdoor play equipment 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. Areas around and/or under climbing equipment have cushioning material to absorb a fall. LPA did not observe any bodies of water during this visit. Director states there are no weapons or firearms on the premises.

Sign in and out sheets 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. Staff Records were reviewed to ensure that a health screening report and required immunization records are on file. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Verification of CPR/First Aid and health preventative practices documentation was verified. Mandated reporter certificates were verified and complete.

This facility does provide Incidental Medical Services – IMS. 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-care-centers/.

Criminal clearance was checked. 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.

REPORT CONTINUED ON LIC 809C PAGE(3)*****

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sikia Blue	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: YMCA OF THE EAST BAY - LONE TREE ELC	FACILITY NUMBER: 073408944
	VISIT DATE: 05/14/2024

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PAGE(3)****

Last fire drill conducted 04/02/2024

Director 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.

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

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 the director, Shamaica Walker

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sikia Blue	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

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