010214881-8-31-2023-02-CC-ILOA-CV8TES-20230831144026

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010214881
Report Date: 08/31/2023
Date Signed: 08/31/2023 02:40:40 PM

Document Has Been Signed on 08/31/2023 02:40 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:	BUSD - HOPKINS STREET		FACILITY NUMBER:	010214881
ADMINISTRATOR:	ROBINSON, K & CARRIEDO, M.		FACILITY TYPE:	850
ADDRESS:	1810 HOPKINS STREET		TELEPHONE:	(510) 644-8939
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94707
CAPACITY: 140	TOTAL ENROLLED CHILDREN: 140	CENSUS: 28	DATE:	08/31/2023
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Linda Morgan		TIME COMPLETED:	02:49 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 August 31, 2023 at 11:45am, Licensing Program Analyst (LPA) Indira Loza met with Facility Representative Linda morgan for the purpose of conducting an annual inspection. There were 28 preschool-age children and 12 fingerprint cleared staff. The teacher/child ratio was met. The facility was toured for a health and safety check. The hours of operation are 7:45am-5pm Monday through Friday. CLASSROOMS: The preschool operates out of four classrooms and two outdoor play spaces. There were play and learning materials available for the children. The floors, furniture, and equipment are age appropriate and in good repair. There was adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. The center utilizes water from the tap for drinking water and cups are provided. The children drink water from a fountain when they are outside. LPA observed ample individual storage space for each child. The center has a smoke detector, a carbon monoxide detector, working telephone, and pull down fire alarm system. This facility has a separate bathroom for the children and the staff. The sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets. There were supplies available to the children. LPA observed a 2A10BC fire extinguisher in each classroom. FOOD SERVICE AREAS: This facility provides breakfast, lunch, and two snacks. LPA observed the food preparation areas to be clean and free from any hazards. OUTDOOR PLAY AREAS: LPA observed two anchored play structures with cushioning to absorb falls. There were plenty age-appropriate toys and activities for the children to play with. LPA observed sufficient shade for the children in care. ISOLATION AREA: The isolation area is in the Administration Office. RECORDS: All individuals subject to a criminal record review have a clearance. Mandated Reporter Training was current for staff. There is an Opening and a Closing staff with CPR certification on site. All required documents are posted in a publicly accessible area. The last fire drill was conducted on May 25, 2023. This facility ****************************Report Continues on LIC 809-C***********************

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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: BUSD - HOPKINS STREET	FACILITY NUMBER: 010214881
	VISIT DATE: 08/31/2023

NARRATIVE

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provides IMS. LPA reviewed the storage of medications and children records. There were two children's records that did not have the Authorized staff to administer the medication listed. This is a Type B violation.

- 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 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-care-centers/.

-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. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22-05-CCP Page Four. CCC has completed testing and remediated a drinking fountain with an exceedance. LPA referred Director Pletcher to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

- 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. -
- Facility Representative Linda Morgan 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. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
- Facility Representative Linda Morgan 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.

See LIC809-D for Type B deficiency.

Exit interview conducted and report was reviewed with the Facility Representative Linda Morgan.
A notice of site visit was given and must remain posted for 30 days.
Appeal rights were provided.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/31/2023 02:40 PM - It Cannot Be Edited

Created By: Indira Loza On 08/31/2023 at 01:52 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: BUSD - HOPKINS STREET	FACILITY NUMBER: 010214881
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/31/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101226(e)(3)(B)

Health-Related Services

(3) Prescription medications may be administered if all of the following conditions are met: (B) For each prescription medication, the licensee shall obtain, in writing, approval and instructions from the child's authorized representative for the administration of the medication to the child. 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 in 2 out of 3 prescriptions did not have the authorization staff to administer medication listed, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/15/2023
	Plan of Correction
1 2 3 4	Director shall email a complete "Medication Consent and Training Documentation" form for the 2 of 3 records missing the authorized persons to administer medication.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Mayla Mendoza

LICENSING EVALUATOR NAME:

Indira Loza

LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

LIC809 (FAS) - (06/04)

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