010200602-6-9-2023-02-CC-RHAR-CSMQBD-20230609120121

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010200602
Report Date: 06/09/2023
Date Signed: 06/09/2023 12:01:54 PM

Document Has Been Signed on 06/09/2023 12:01 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	SKYLINE PRE-SCHOOL		FACILITY NUMBER:	010200602
ADMINISTRATOR:	CORSON, NAOMI		FACILITY TYPE:	850
ADDRESS:	12540 SKYLINE BOULEVARD		TELEPHONE:	(510) 530-0884
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94619
CAPACITY: 34	TOTAL ENROLLED CHILDREN: 39	CENSUS: 24	DATE:	06/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:08 AM
MET WITH:	Naomi Corson		TIME COMPLETED:	12:10 PM

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On June 9, 2023 at approximately 8:08am, Licensing Program Analyst (LPA) Russ Haderer arrived unannounced for an annual inspection for compliance to Health and Safety. Present for the inspection was the site director Naomi Corson, five teachers and 24 children in care (3 to 5 years in age). The center is in ratio today. The hours of operation are 8:00 to 5:30pm.

The center is operated on the lower level of the Skyline Community Church, with three classrooms (the main classroom has been dived due to covid protocol). LPA toured all areas utilized for child care with facility director, Naomi Corson.

The facility is clean and well organized with ample age appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. Heating and ventilation is acceptable in the buildings. There were no hazardous items/toxins observed to be accessible to children in care today. There are no bodies of water accessible to children in care. First aid supplies are available in the center. Any child that becomes ill during the day is kept isolated in the classroom away from the other children in care.

LPA observed that all preschool rooms are clean and safe for all children and staff. Children bring their own bottled water from home, each one labeled with their name. Water is also available via working water fountains, water pitchers and cups. Children bring their own lunch; snacks are provided by the facility. Snack food and beverages were checked and not expired. The center has a small kitchenette, no cleaners or toxic materials were observed stored with food prep and storage areas appear clean and free of pests. Sleeping cots are used for children napping and linens are stored and used individually per child.
The center has fully charged 3A40BC fire extinguishers, the last annual inspection was done 6-29-2022. Combined smoke alarm / carbon monoxide detectors were available in each classroom, all tested and working. The facility has a centralized pull fire alarm system, the most recent fire department inspection was 07-14-2022. Disaster drills are conducted at least once every 6-months, the last drill was completed 6-08-2023.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: SKYLINE PRE-SCHOOL	FACILITY NUMBER: 010200602
	VISIT DATE: 06/09/2023

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Sinks and toilets are age appropriate and in good repair; restrooms contain enough towels and soap supplies. All toilets, handwashing and cleaning areas are in safe and sanitary operating condition. There are solid waste containers with tight-fitting lids. There is a separate staff bathroom located on the top floor in the administration office area, not used by children.

Director stated that there are no weapons or firearms on the premises. Center provides IMS service for two children, proper consent forms were signed and dated by parents, medications were checked and not expired.

The play ground/outdoor area is fully enclosed/fenced. There is shade available and climbing structures/equipment are age appropriate and securely anchored with cushioning under and around the equipment. Play equipment appears free of broken/sharp pieces. There are no observed hazardous conditions and no accessible bodies of water are present.

The sign in/out is done manually, signatures to children present was checked and all children were signed in.

LPA reviewed the facility, personnel and children's records including children's health screenings, immunization records, and parents' rights forms, staff teaching qualifications and staff background clearances. LPA requested and reviewed facility roster, all files selected were complete and up to date. All required postings are present. Multiple staff present have current CPR/First Aid certification.

Site Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: SKYLINE PRE-SCHOOL	FACILITY NUMBER: 010200602
	VISIT DATE: 06/09/2023

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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

There were no deficiencies issued today. A copy of this report will remain on file for three years.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the site Director Naomi Corson.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

LIC809 (FAS) - (06/04)

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