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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010216108
Report Date: 11/28/2023
Date Signed: 11/28/2023 01:30:39 PM


Document Has Been Signed on 11/28/2023 01:30 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, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:OAKLAND HEAD START - TASSAFARONGAFACILITY NUMBER:
010216108
ADMINISTRATOR:LISA ROSSFACILITY TYPE:
850
ADDRESS:975- 85TH AVENUETELEPHONE:
(510) 639-0580
CITY:OAKLANDSTATE: CAZIP CODE:
94621
CAPACITY:25CENSUS: 5DATE:
11/28/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lisa RossTIME COMPLETED:
01:40 PM
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On 11/28/23 at 9:30am, Licensing Program Manager (LPM) Loretta Dyson and Licensing Program Analyst (LPA) Sikia Blue arrived at the facility for an unannounced required inspection. LPM and LPA met with Lisa Ross, the director. There were 5 children, one additional staff member, and a mental health advocate also present. This program operates 8:30am-4:30pm, Monday - Friday in one classroom in the Tassafaronga Recreation Center.

LPM and LPA completed a tour of the classroom, multi-purpose room, bathroom and playground, to conduct a health and safety inspection. LPM and LPA observed that the classroom has sufficient heating, lighting and ventilation for the safety and comfort of children and staff. The floors and surfaces appear to be safe and in good repair. There is an ample supply of age appropriate furniture, toys, activities and equipment which appear to be in good condition. There is adequate storage for children's belongings. The bathroom has 2 sinks and 3 toilets available for children, and LPA observed that they were in sanitary and operational condition. There is one additional sink inside of the classroom area. There is a separate bathroom available for staff. The isolation area is in the facility office, and either the staff bathroom or a separate stall inside of the children's bathroom will be used for sick children. Meals for children are delivered from the main site for Oakland Head Start. LPM and LPA observed that the food preparation area was clean and food was not stored with cleaning supplies. The facility provides low fat milk for children. The refrigerator and freezer were observed to be clean. The facility has a menu, which is dated at least a week in advance, posted on the parent board. The facility has water pitchers and disposable cups to provide children water indoors and outdoors. LPM observed that all containers used for storage of solid waste are in good repair and have a tight fitting cover that is kept on. LPM did not observe any bodies of water, hazardous items, toxins or medication accessible to children today. All required forms are posted on the parent board. The last documented fire/disaster drills were conducted on 10/11/2023. The center is equipped with first aid supplies, a working telephone, working combination smoke/carbon monoxide detector, and fully charged 4A80BC fire extinguisher.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: 510-695-0243
LICENSING EVALUATOR SIGNATURE:
DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2023
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: OAKLAND HEAD START - TASSAFARONGA
FACILITY NUMBER: 010216108
VISIT DATE: 11/28/2023
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The outdoor play space is fully fenced. There is sufficient cushioning underneath the play structure to absorb a fall, and LPM observed that the play structure is secure and age appropriate.

The facility has a backpack that is hung high up on the door, for the medication. LPM observed that the medication is current and inaccessible to children. The instructions from the doctor are attached to the medication, and in the file. LPM observed the interaction between the staff and children in care and found it to be in compliance with the Title 22 Regulations.

At 10:30am, LPA began the review of staff files. All staff have a criminal record clearance, required training, and qualifications. At least one staff member that opens and closes the center has current CPR/First Aid certificates. At 10:50am LPA began the review of children's files. There is a separate, complete and current file maintained for all children. The center is in ratio today, and abiding by the capacity specified on the license. All children were signed in on the sign in sheet, and the facility is in compliance with the sign in/out procedures.

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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP). LPM verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. There was no lead exceedance found for any outlets tested.

Licensee 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.

SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: 510-695-0243
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023
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: OAKLAND HEAD START - TASSAFARONGA
FACILITY NUMBER: 010216108
VISIT DATE: 11/28/2023
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This facility provides Incidental Medical Services – IMS. LPM reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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-carecenters/.

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. Appeal Rights were provided. There are no deficiencies being cited as a result of today's inspection.

Exit interview conducted and report was reviewed with the Lisa Ross.

SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: 510-695-0243
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023
LIC809 (FAS) - (06/04)
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