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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010215106
Report Date: 12/15/2021
Date Signed: 12/22/2021 11:48:37 AM

Document Has Been Signed on 12/22/2021 11:48 AM - 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:OUSD - LOCKWOODFACILITY NUMBER:
010215106
ADMINISTRATOR:DAMONICA ROBINSONFACILITY TYPE:
850
ADDRESS:1125 69TH AVENUETELEPHONE:
(510) 879-0823
CITY:OAKLANDSTATE: CAZIP CODE:
94621
CAPACITY: 48TOTAL ENROLLED CHILDREN: 42CENSUS: 26DATE:
12/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Damonica RobinsonTIME COMPLETED:
04:30 PM
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On 12/15/2021 at 9:30am Licensing Program Analyst (LPA) Diana Campos arrived at the facility and met with Supervising Teacher Damonica Robinson for a 1 year required inspection. Present during the inspection were 6 staff, and 26 preschool children in care. This program operates in Rooms 1A and 1B. Hours of operation are Monday-Friday 8:00 am - 3:00pm.
LPA toured the facility and play yard for a health and safety inspection. Staff files are maintained at the District office. As a condition of their employment, all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The teacher/child ratio was being met. Children's files are maintained at the Enrollment Center and 8 files were made available for review today. The classroom(s) and play yard were age appropriate. There is adequate heating, ventilation and lighting. Floors were clean and safe. Classroom furniture is in good condition. There are toys, books, crafts and educational supplies available. There is proper storage areas for each child with cubbies. Bathrooms were clean and in working order. Children are able to reach the sinks, and there is adequate bathroom supplies. Hand soap and paper towels were available for children. Meals and snacks are provided by the school district. The kitchen area was maintained in a clean manner and was inaccessible to children in care. The storage of napping equipment was appropriate. The sign in and out electronic logs were reviewed. The facility license is posted for public review. The last fire/emergency drill was in December 2021. Director and Designation of Facility Responsibility is current. Menus are emailed to parents on a monthly basis via the school district. Site Supervisor was reminded to keep a current printed copy of the menu posted and available for review at all times. There is a 2A10BC fire extinguisher, hard wired smoke detectors and carbon monoxide detector. Outdoor play area provided a shaded area for the children, LPA observed an age appropriate play structure that is anchored to the ground with adequate cushioned material to absorb a fall. For drinking water, children have access to their own personal water bottle on demand. Medications, when dispensed, are stored on a high shelf in a cabinet which is inaccessible to children in care. There is a working telephone at the facility. There were no bodies of water or firearms on the premises. There is a First aid kit on the premises. Director has emergency earthquake supplies. Cleaning supplies are inaccessible to children, placed in a locked storage room. (continued)
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2021
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: OUSD - LOCKWOOD
FACILITY NUMBER: 010215106
VISIT DATE: 12/15/2021
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8 children's files were made available to LPA and reviewed at 2:00pm. They list emergency information. A roster was available. Staff records are maintained at the district office. Clearances are through OUSD. Mandated Reporter Training http://www.mandatedreporterca.com was discussed. Required training will need to be completed every 2 years. Director's CPR expires 11/11/2022. All individuals subject to a criminal record review have obtained clearances and Health Screenings through Oakland Unified School District.

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

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

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.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
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: OUSD - LOCKWOOD
FACILITY NUMBER: 010215106
VISIT DATE: 12/15/2021
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LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Center Director Kianga Lee.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
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