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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010209917
Report Date: 05/01/2023
Date Signed: 05/01/2023 01:09:13 PM

Document Has Been Signed on 05/01/2023 01:09 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:ALBANY PRESCHOOLFACILITY NUMBER:
010209917
ADMINISTRATOR:MARTLING, N & BERNOS, SFACILITY TYPE:
850
ADDRESS:850 MASONIC AVENUETELEPHONE:
(510) 527-2281
CITY:ALBANYSTATE: CAZIP CODE:
94706
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
05/01/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Nancy MartlingTIME COMPLETED:
01:23 PM
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On Monday, May 1, 2023 at 10:25 AM, Licensing Program Analyst (LPA) Caroline Colson, arrived at the facility and met with Nancy Martling, Center Director, to conduct an annual required inspection. A Health and Safety Inspection was conducted. LPA made the following observations:

Capacity/Staffing: There are 20 preschool children present with 4 teachers in two classrooms.

Physical Plant: The facility consist of one (2) classroom in one converted house. There is one (1) bathroom with two toilets. There is adequate heating, lighting and ventilation. There are no cleaning solutions, chemicals or other hazards accessible to children.

Classrooms: Furniture and equipment age appropriate and in good repair. There are separate storage areas for children’s belongings. Children do take naps at facility. Napping equipment is cleaned every week by parents. Parents provide all the food for their children.

Restrooms: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use.

Play yard: Climbing structures, slides are safe and in good condition. Playground is free of debris and other hazards. Children have their individual water bottles. There are no pools, hot tubs or other bodies of water present.

Please LIC 809 C for additional information
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE: DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/01/2023
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: ALBANY PRESCHOOL
FACILITY NUMBER: 010209917
VISIT DATE: 05/01/2023
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Emergency Preparedness/Safety: Smoke detector was inspected by an outside company. Carbon monoxide detector was tested and is working. The are two 3A40BC fire extinguishers which were serviced in 2023. Pediatric CPR and First Aid Certificates are current and expire on February 28, 2025. First Kit is available and complete. Emergency Disaster Plan is posted. The facility utilizes a land line telephone.


Postings: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist.

Sign in Sheet/Class Roster: All parents sign in and sign out. The roster is current and available.

Training/Record Review:
All staff present on this date have criminal background clearances. Director has current CPR/First Aid and Mandated Reporter certificates on file. Immunization records including influenza and or a statement declining vaccination.

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

Facility Representative 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.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
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: ALBANY PRESCHOOL
FACILITY NUMBER: 010209917
VISIT DATE: 05/01/2023
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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/process.

As a result of this inspection, there are no deficiencies cited during today's inspection.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Facility Representative, Nancy Martling

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
LIC809 (FAS) - (06/04)
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