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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010216109
Report Date: 12/12/2023
Date Signed: 12/12/2023 02:12:32 PM

Document Has Been Signed on 12/12/2023 02:12 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 - BROOKFIELDFACILITY NUMBER:
010216109
ADMINISTRATOR:ORURUO, VIVIANFACILITY TYPE:
850
ADDRESS:9600 EDES AVENUETELEPHONE:
(510) 615-5737
CITY:OAKLANDSTATE: CAZIP CODE:
94603
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 0DATE:
12/12/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Joy CironTIME COMPLETED:
02:20 PM
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On 12/12/23 at 12:35pm, Licensing Program Manager (LPM) Loretta Dyson arrived at the facility for an unannounced required inspection. LPM with Joy Ciron. There were no children and one other staff present. The facility is closed today, due to a power outage. This program operates 8:30am-4:30pm, Monday-Friday, in one large classroom divided by a small shelf.

LPM conducted a tour of the classroom, bathrooms, kitchen and playground, to conduct a health and safety inspection. The floors and surfaces appear to be safe and in good repair. There is an ample supply of age appropriate furniture, toys, activities and equipment which appear to be in good condition. There is adequate storage for children's belongings. The facility has cots which are stored appropriately. The bathrooms are clean and there are 3 toilets and 4 sinks available for children. There is one additional sink inside of the classroom area. There is a separate bathroom available for staff. The isolation area is in the an area of the classroom, away from other children where there is a couch. The staff bathroom will be used for sick children. Meals for children are delivered from the main site for Oakland Head Start. The facility has a menu, which is dated at least a week in advance, posted on the parent board. The facility has water pitchers and disposable cups to provide children water indoors and outdoors. LPM observed that all containers used for storage of solid waste are in good repair and have a tight fitting cover that is kept on. LPM did not observe any bodies of water, hazardous items, toxins or medication accessible to children today. All required forms are posted on the parent board. The last documented fire/disaster drills were conducted on 11/29/23 and 11/30/23. The center is equipped with first aid supplies, a working telephone, working smoke and carbon monoxide detection system, and fully charged 3A40BC fire extinguishers. The outdoor playground is fully fenced. There is sufficient cushioning underneath the play structure to absorb a fall, and LPM observed that the play structure is secure and age appropriate. There is shade from the tree and a cover over the play structure. The facility keeps a backpack that is hung high up on the wall, for the medication, making it inaccessible to children.
SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2023
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: OAKLAND HEAD START - BROOKFIELD
FACILITY NUMBER: 010216109
VISIT DATE: 12/12/2023
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Staff and children's records have been moved to other sites where children and staff will temporarily be until this facility reopens. Licensing will return to complete a review of files when the facility reopens. All staff have a criminal record clearance, required training, and qualifications as a requirement of the City of Oakland. The director verified that at least one staff member that opens and closes the center has current CPR/First Aid certificates. The director verified that all children are signed in on the sign in sheet, and the facility is in compliance with the sign in/out procedures.

Licensee 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.

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. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP). LPM verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. There was no lead exceedance found for any outlets tested.

Licensee 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.

This facility provides Incidental Medical Services – IMS. LPM 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-carecenters/.

SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
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 - BROOKFIELD
FACILITY NUMBER: 010216109
VISIT DATE: 12/12/2023
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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.

A Notice of Site Visit was given and must remain posted for 30 days. Appeal Rights were provided. There are no deficiencies being cited as a result of today's inspection.

An exit interview was conducted and report was reviewed with the teacher, Joy Ciron.

SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023
LIC809 (FAS) - (06/04)
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