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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010215033
Report Date: 10/13/2022
Date Signed: 10/13/2022 04:28:39 PM

Document Has Been Signed on 10/13/2022 04:28 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 - MANZANITAFACILITY NUMBER:
010215033
ADMINISTRATOR:LINDA FRAZIER-MOOREFACILITY TYPE:
850
ADDRESS:2701 - 22ND AVENUETELEPHONE:
(510) 535-5627
CITY:OAKLANDSTATE: CAZIP CODE:
94606
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 8DATE:
10/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Terry ChenTIME COMPLETED:
03:40 PM
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LPA Dyer met with Director Terry Chen for an unannounced Required - 1 Year Inspection. Present are 4 staff (3 teacher qualified and 1 aid) and 8 preschool children. There is one classroom. Sign-in/sign-out sheets list the time and parents' signature. There is a working phone. Fire/emergency drills are held monthly - the last drill was in September, 2022. Director and Designation of Facility Responsibility will be updated. There is a carbon monoxide detector and a fire extinguisher.
Classroom furniture is in good condition. There are toys, books, crafts and educational supplies available. Floors were clean and safe. There is adequate heating, ventilation, and lighting. LPA did not observe any child left without visual supervision or unattended during the inspection. Bathroom toilets and sinks are working properly. Children are able to reach the sinks, but there are also broad based platforms that the children can use, if needed. There were adequate bathroom supplies. Kitchen area (including storage areas for food) was clean. No insects or pests were seen. There were storage containers with lids for solid waste in the kitchen. A sample of food product was examined for freshness and expiration dates. Food is prepared outside the facility at a central kitchen. The center supplies breakfast, lunch
and snacks. Menus were posted. Inside, there is proper storage areas for each child with cubbies. There is adequate napping equipment (mats). Blankets are washed at the center. There is drinking water available at all times inside and outside the center through dispensers and paper cups. Isolation area for sick children is near the kitchen. Director stated that there were no bodies of water or firearms on the premises. First aid kit is located in cabinet. Director has emergency earthquake supplies. Proper posting requirements were met. Cleaning supplies and other items hazardous to children are inaccessible, locked in the kitchen and in the storage area.
Outside play area (securely fenced) is safe and free of hazards. There were a variety of toys and play materials such as slides, soft cushion seats, riding toys, balls, easel, etc. There is an outside shaded area. Supervision of children outdoors was discussed in detail.
(continued)
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2022
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 - MANZANITA
FACILITY NUMBER: 010215033
VISIT DATE: 10/13/2022
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New Regulations were discussed: Required Lead Testing for Drinking Water - A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.
Incidental Medical Services (IMS) policy was discussed. This facility plans to provide Incidental Medical Services. A 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. Medications are locked in the classroom, inaccessible to children.
Children's files were examined at 1:00 p.m.
Employee records were examined at 1:47 p.m. Director's Mandated Reporter Training, CPR/First Aid, immunization/medical records are current. The director stated that at least one person trained in CPR/First Aid is always present. All individuals subject to a criminal record review have obtained clearance or a criminal record exemption.
Websites:
Community Care Licensing General Information:www.ccld.ca.gov. Mandated Reporter Training: www.mandatedreporterca.com
Alameda County Public Health Department Website: www.acphd.org
Guardian: background check process with self-service options: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

There are no deficiencies cited today.

Exit interview conducted. Director was provided a copy of their appeal rights. Notice of site visit was posted at the time of the inspection, and must remain posted for 30 days.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022
LIC809 (FAS) - (06/04)
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