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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700656
Report Date: 07/19/2024
Date Signed: 07/19/2024 01:11:40 PM

Document Has Been Signed on 07/19/2024 01:11 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:CAPE JOE MICHELL CENTERFACILITY NUMBER:
015700656
ADMINISTRATOR/
DIRECTOR:		HANEEN ASADFACILITY TYPE:
860
ADDRESS:1001 ELAINE AVETELEPHONE:
(925) 337-1226
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 0DATE:
07/19/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Regina Garcia and Aida WhiteTIME VISIT/
INSPECTION COMPLETED:
01:25 PM
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On Friday, July 19, 2024, at 10:30 AM, Licensing Program Analyst, (LPA) Caroline Colson met with Applicant Regina Garcia, and Support Services Manager, Aida White for Change of Location prelicensing inspection. The applicant requests 20 preschool children from 2 years of age to first grade entry. A health and safety inspection in all areas accessible to children was conducted. There are no children and staff present. The program will operate Monday through Friday from 8:00 AM to 5:00 PM.

Physical Plant: The facility is a classroom within a elementary school building. The facility will be using one classroom, D19. There are restrooms for children and staff. There is adequate heating, lighting, and ventilation. There are no cleaning solutions, chemicals, or other hazards accessible to children. Per Applicant, there are no weapons at the facility.

Classroom: Furniture and equipment are age appropriate and in good repair. There are separate storage areas for children’s belongings. Drinking water will be provided in an uncontaminated water pitcher for all children. Children do take naps at facility. There are cots and bedding materials for all the children. Staff will wash all bedding materials and sanitized all cots every Friday. There is a first aid kit and emergency disaster bag is available for use. The facility provides breakfast, lunch and an afternoon snack. The menu is posted for review. Food will be provided through an off campus facility.

Please See LIC 809 C for Additional Information
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2024
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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAPE JOE MICHELL CENTER
FACILITY NUMBER: 015700656
VISIT DATE: 07/19/2024
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Restrooms: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use.

Classroom measurements:
LPA measured one (1) classroom for the Preschool Component. The total indoor measurements are 1,017.83 square feet which will accommodate Applicant's request for 20 Preschool children.

There are three (3) sinks, and one (1) toilet for the children, and a separate restroom for the staff located near the classroom. Staff bathroom and director's desk are the isolation areas.

Outdoor Activity Space:
There is one outdoor area on the property. The outdoor play area is fenced with a chain link fence and building wall that are at least four feet tall. There is enough age-appropriate equipment and toys. The play structure includes a safety label but doesn't classify the ages of the children. There is an additional sign stating adult supervision is needed. There is cushioning material underneath all outdoor climbing equipment. There is a shaded area and available seats for the children. There are no bodies of water on the premises. Climbing structure and slides are safe and in good condition. Playground is free of debris and other hazards. Children have access to drinking water.

The total available outdoor space is 6,804.86 square feet, which will accommodate the Applicant's request for 20 Preschool children.


Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Please See LIC 809 C for Additional Information
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2024
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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAPE JOE MICHELL CENTER
FACILITY NUMBER: 015700656
VISIT DATE: 07/19/2024
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Emergency Preparedness/Safety: Emergency Disaster Plan is dated. The facility utilizes a land line telephone. Fire Clearance was received on June 19, 2024.

Sign in/Sign out: Applicant stated an electronic sign in and sign out process will be utilized, and paper sign in/sign out is also available.

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.

LPA advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.

Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure. LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Applicant 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.

Please See LIC 809 C for Additional Information
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2024
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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAPE JOE MICHELL CENTER
FACILITY NUMBER: 015700656
VISIT DATE: 07/19/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and ADA, available at http://www.ada.gov/childqanda.htm

LPA reviewed with Applicant the LIC 311 A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

LPA discussed 100% supervision is always required in all areas that children have access to including the bathroom. Personal Rights, inspection authority, reporting requirements, maintaining buildings and grounds was reviewed. Staff Qualifications, Staff to Children’s ratios and Capacity was explained to ensure compliance. LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Applicant 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.

See LIC 809 C for Additional Information
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2024
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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAPE JOE MICHELL CENTER
FACILITY NUMBER: 015700656
VISIT DATE: 07/19/2024
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Exit interview was conducted by Applicant, Regina Garcia:
1. Applicant will need to submit another facility sketch to include the location of the additional toilet needed for the requested maximum capacity.
2. Applicant will need to post the Emergency Disaster Plan, LIC 610.
3. Licensing Program Manager (LPM) final file review
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2024
LIC809 (FAS) - (06/04)
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