Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010213812
Report Date: 11/17/2017
Date Signed: 11/17/2017 12:37:57 PM

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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:EMERYVILLE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
010213812
ADMINISTRATOR:PORTER, LOISFACILITY TYPE:
850
ADDRESS:1220 - 53RD STREETTELEPHONE:
(510) 596-4343
CITY:EMERYVILLESTATE: CAZIP CODE:
94608
CAPACITY:66CENSUS: 26DATE:
11/17/2017
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Samantha Golden and Susan StevensonTIME COMPLETED:
01:00 PM
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A Case Management inspection was conducted today by Licensing Program Analysts (LPA) Wynn Norona and Cherie Acosta. An application was submitted to increase capacity for the Preschool program from 66 to 90 children. This is a combination center with an Infant component (#010213813). The former Toddler room next to the Multipurpose Room will now be added to the Preschool program. The program will continue to operate Monday through Friday from 7:30am to 6pm. There are 26 preschoolers with 6 fingerprint cleared staffs present today. A health and safety inspection was conducted inside and outside and the measurements are as follows:

INDOOR: 3460.8 square feet = 99 children
OUTDOOR: 4897.99 square feet= 65 children

The center has obtained an approved fire clearance from Emeryville Fire Department on 11/3/17. There are no bodies of water nor any firearms or weapons in the premises. Storage for cleaning supplies are locked and made inaccessible to children. Furniture and equipment are free of any hazards. The classrooms are equipped with age appropriate materials and equipment. There is a carbon monoxide detector, smoke detector, and fire extinguishers are available all throughout the center. Heating, lighting, and air conditioner are adequate. First Aid Kit is available. Each child has individual storage for their belongings. The play yard is fenced in all around. Play structures are sufficiently cushioned. Shades and building overhang provide sufficient shade in the play yard.
There is an existing approved waiver for outdoor play yard. An updated waiver is being requested to allow no more than 65 children in the play yard by scheduling the time children will play outside. The Multipurpose Room is a shared space with Preschool and Infant and commingling between two program is never allowed. The center will set a schedule for the use of the room. Licensing postings are visible for public views and correctly posted on the wall. The sign in/out sheet provide for parent’s full signature. LPA reminded Ms. Stevenson to sanitize and clean the toys/play equipment periodically. Water is available inside and outside. There are 10 toilets and 8 sinks available for children. The staff has a separate bathroom. The office will serve as isolation area for sick children while waiting for parents to pick them up. The kitchen is not accessible to children. The center will provide lunch, morning and afternoon snacks. There is a sample menu posted on the Licensing board.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Wynn NoronaTELEPHONE: 510-542-4257
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2017
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: EMERYVILLE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 010213812
VISIT DATE: 11/17/2017
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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 the ADA, available at: http://www.ada.gov/childqanda.htm

Zero Tolerance policies were explained. The center was found to be clean, safe, sanitary, and in good repair. An exit interview was conducted with applicant, Ms. Stevenson. LPA provided a copy of the appeal rights and the signature on this form acknowledges receipt of these rights. Assembly Bill 633 Fact Sheet was given and discussed with the director. Notice of Site visit was posted at the time of inspection, and must remain posted for 30 days.

A license for 90 preschool children is recommended effective today, November 17, 2017.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Wynn NoronaTELEPHONE: 510-542-4257
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2017
LIC809 (FAS) - (06/04)
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