<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700559
Report Date: 01/04/2022
Date Signed: 01/04/2022 01:29:28 PM

Document Has Been Signed on 01/04/2022 01:29 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:YMCA OF THE EAST BAY-JOHN MUIRFACILITY NUMBER:
015700559
ADMINISTRATOR:SHAW, PAMMFACILITY TYPE:
850
ADDRESS:24823 SOTO ROADTELEPHONE:
(510) 848-9092
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 0DATE:
01/04/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Carla Cooper/Monica WilliamsTIME COMPLETED:
01:48 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 1/4/2022, a Prelicensing Visit was conducted today by Licensing Program Analyst (LPA), Melanie Otsuji. LPA met with Director of Field Operations, Carla Cooper and Area Manager, Monica Williams. The applicant has submitted an application for a PRESCHOOL license. A health and safety inspection was conducted inside and outside. The preschool program will operate in 2 classrooms (Classrooms 6 and 7). Also on site is an Infant Component with Toddler Option operating out of 4 classrooms (Classroom 8A/8B and 9A/9B). This is a TITLE V facility operating on the campus of Hayward Unified School District's John Muir Elementary School.. Operating hours Monday through Friday from 7:30AM - 5:00PM. The measurements are as follows:

INDOORS: 1560.27 square feet = 45 children
OUTDOORS: 5800.76 square feet = 77 children

Measurements were taken of each room and of the out door play yard. There is a separate staff bathroom and it will be utilized for an isolation restroom if a child becomes ill. There is a fully stocked first aid kit with all required equipment available and a locked box for stored medications. No exit doors were blocked. There is ample toys and furnishings throughout the center for children's use. There are cots and mats available for children.
There are 6 toilets (sized appropriately) and 8 sinks available for children's use. Heating and lighting was adequate. There is ample play space for the children. There is a concrete play yard for the preschool aged children. Additionally, on rainy days, the preschool aged children will have access to the Multi-Purpose Room which will function as a gross motor skills room only. The center Director will be Daisy Amezcua and a directors packet with all required documentation was submitted to CCL to complete the application. The Hayward Unified School District will provide lunch and AM/PM snacks to the children. Facility will have back up snacks on hand. LPA is awaiting the approval of the fire clearance for both the preschool and infant center.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 01/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/04/2022
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YMCA OF THE EAST BAY-JOHN MUIR
FACILITY NUMBER: 015700559
VISIT DATE: 01/04/2022
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
There are no bodies of water nor hazards found on the premises. Playground equipment is in good condition. Drinking water is available inside and outside. All toilets and hand washing facilities are in safe and sanitary operating conditions. All licensing required documents are posted. This facility plans to provide Incidental Medical Services - IMS. 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

A license for 45 preschoolers operating out of 2 classrooms (Classrooms 6 & 7) will be approved once an approved fire inspection clearance is received.

An exit interview was conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 01/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2