Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010213812
Report Date: 04/20/2018
Date Signed: 04/20/2018 11:24:32 AM

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:90CENSUS: 43DATE:
04/20/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Quera OwensTIME COMPLETED:
11:40 AM
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Licensing Program Analyst (LPA) Mayla Mendoza conducted an unannounced ANNUAL/RANDOM inspection. LPA met with Child Development Manager Quera Owens. The center was toured inside and out for health and safety inspection.
PHYSICAL PLANT: There are no bodies of water nor any firearms/weapons in the premises. Storage for poisons/detergents, cleaning supplies, medications are inaccessible to children. Furniture and equipment are free of sharp parts. Indoor and outdoor surfaces are clean and toxic free. Toilets, handwashing equipment are safe and in sanitary condition. There are separate staff toilets. Kitchen and food-preparation area are clean. Food are protected against contamination. There is a menu posted and there are no cleaning supplies stored with food. Breakfast, lunch and snacks are provided by the center. Parents provide lunches for their children. There is a variety of snacks available for children. Water is available indoors and outdoors. The center is free of flies, other insects and rodents. LPA inspected the fire extinguisher, smoke detector, and carbon monoxide detector. First Aid kit is available. Heating, lighting and air conditioner is adequate. INSPECTION of OUTDOOR PLAY AREA: Playground equipment is in good condition and outdoor activity space is maintained in a safe condition and free of any hazards. Climbing equipment is properly anchored to the ground with adequate and appropriate cushioning material to absorb falls. There is an adequate shade provided for the children. FACILITY ADMINISTRATION: The staff is aware that any authorized employee of the Department may enter and inspect the center with or without advance notice. The licensee understands that prior to working or volunteering in a licensed child care facility, all individuals subject to criminal record review shall obtain a clearance or criminal record exemption. If the department notifies the licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons, the licensee shall comply. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at off site activities. EVALUATION OF CARE AND SUPERVISION: The facility is operating within its licensed capacity. The facility is within ratio today with one teacher supervising no more than 12 children.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Mayla MendozaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2018
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: 04/20/2018
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RECORD REVIEW: A physical census was taken of all children present and cross-referenced with the sign in and out sheet. LPA reviewed a percentage of children and staff records. Opening and closing staff have current CPR and first aid training. LPA obtained a copy of the most current LIC500. POSTING REQUIREMENTS: License and other relevant notices are visible for public views and correctly posted on the wall. Fire and disaster drills are being conducted as scheduled every six months. Ms. Owens was reminded to inform all the staff to complete the mandated reporting training by visiting www.mandatedreporterca.com
LPA verified that the center is following their Incidental Medical Services (IMS) Plan of Operation. Ms. Owens was encouraged to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

Exit interview was conducted with Child Development Manager, Quera Owens. Notice of Site visit was posted at the time of inspection and must remain posted for 30 days.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Mayla MendozaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2018
LIC809 (FAS) - (06/04)
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