<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010214250
Report Date: 06/16/2023
Date Signed: 06/16/2023 02:49:23 PM

Document Has Been Signed on 06/16/2023 02:49 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:EPHESIAN CHILDREN'S CENTERFACILITY NUMBER:
010214250
ADMINISTRATOR:MCDONALD, NEWTFACILITY TYPE:
840
ADDRESS:1907 HARMON AVENUETELEPHONE:
(510) 653-2984
CITY:BERKELEYSTATE: CAZIP CODE:
94703
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 2DATE:
06/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Joyce BarnesTIME COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On June 16, 2023 at 12:45pm, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced for a Required-1 Year inspection. LPA first met with site director Joyce Barnes. Director Dr. Veronica Ufeobune arrived later during visit. There were two children and one additional staff member present during the inspection. This program is part of a combination center which also includes a preschool component. The facility was toured for a health and safety inspection. Hours of operation for child care are Monday through Friday, 7:00am to 6:00pm.

Disinfectants, cleaning solutions, poisons and other items that are dangerous to children were inaccessible during the visit. The toilets and sinks were in operable condition. The floors are free of tripping hazards. The kitchen/food preparation and storage areas appear to be clean and free of evidence of rodents and food is protected against contamination. All storage containers for solid waste have tight-fitting covers that are in good repair. Drinking water is available both indoors and outdoors. Menus are posted and visible for parents to review. There are no pools or similar bodies of water at this facility. Outdoor activity space and playground equipment observed to be safe and free of hazards. Climbing equipment is properly anchored to the ground with adequate and appropriate cushioning material to absorb falls. There is a shaded area provided for the children. Required licensing documents were posted. Fire extinguishers, carbon monoxide and smoke detectors meet State Fire Marshall standards.

The facility is operating within its licensed capacity. The facility is within ratio today with 1 teacher supervising no more than 14 children. LPA did not observe any child left without visual supervision or unattended during the inspection. Children and staff files were reviewed. LPA verified both opening and closing staff have current CPR/First aid training. The center is in compliance with the sign in and out procedure. Fire/Disaster drills are conducted monthly.

***Continued on LIC 809C...
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: EPHESIAN CHILDREN'S CENTER
FACILITY NUMBER: 010214250
VISIT DATE: 06/16/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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

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.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.



The following deficiencies were cited during today's inspection:
  • Upon file review, LPA observed staff S2 does not have a Health Screening (LIC 503) nor proof of measles and pertussis immunizations on file.

See LIC809D for deficiencies cited during today's inspection. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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.

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

Exit interview conducted and report was reviewed with director Dr. Veronica Ufeobune.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 06/16/2023 02:49 PM - It Cannot Be Edited


Created By: Julia Placencia On 06/16/2023 at 02:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: EPHESIAN CHILDREN'S CENTER
FACILITY NUMBER: 010214250

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above as staff S1 does not have proof of measles and pertussis on file. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/16/2023
Plan of Correction
1
2
3
4
Director shall obtain proof of measles and pertussis for S1, and submit a copy to LPA by due date of 7/16/23.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above as S1 does not a completed health screening on file. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/16/2023
Plan of Correction
1
2
3
4
Director shall obtain a health screening report for S1, and submit a copy to LPA by due date of 7/16/23.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Jason Jang
LICENSING EVALUATOR NAME:Julia Placencia
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2023


LIC809 (FAS) - (06/04)
Page: 3 of 3