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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013410074
Report Date: 04/23/2024
Date Signed: 04/23/2024 03:41:41 PM

Document Has Been Signed on 04/23/2024 03:41 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:ECOLE BILINGUE DE BERKELEY PRESCHOOLFACILITY NUMBER:
013410074
ADMINISTRATOR/
DIRECTOR:		BURNETT, CHAUNCEYFACILITY TYPE:
850
ADDRESS:2830 TENTH ST.TELEPHONE:
(510) 549-3867
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY: 100TOTAL ENROLLED CHILDREN: 92CENSUS: 73DATE:
04/23/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Chauncey BurnettTIME VISIT/
INSPECTION COMPLETED:
03:50 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 April 23, 2024 at 9am Licensing Program Analyst (LPA) Indira Loza arrived at the facility to conduct an annual continuation. Director Chauncey Burnett arrived shortly after at approximately 9:15am. There were 73 preschool age children and nine (9) fingerprint cleared staff. The preschool is on an elementary school school campus. The teacher/child ratio was being met today. The center was toured for a health and safety inspection. The facility operates from 7:30am – 6pm Monday through Friday.

Classrooms: The preschool operates out of five (5) classrooms. Classrooms A, B, C, and D are located in the "Preschool Building" and are the mixed age classrooms ranging from 3-5 years old . The "TPS" class serves children from 2-3 years old and is in the elementary school building. All sinks and toilets are observed to be clean and in proper working order. The facility has age appropriate materials in all classrooms that are observed to be clean and in good condition. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. There is water bottle filling station outside on the playground, and pitchers are filled with water from inside the building to provide drinking water when the children are inside the classrooms. Each classroom has a fully charged fire extinguisher and a carbon monoxide detector. The fire system is hard wired.

Outdoor: The outdoor play area is clean with ample age appropriate materials for the children. The center has a waiver for the playground allowing 61 children at a time. The yard is fully fenced in and has plenty of shade for the children. The sandbox is clean from hazardous foreign material. The play structure has a sign from the manufacturer stating the recommended ages to play on the structure is from 2-5 years old. LPA did not observe any harmful or unattended bodies of water in or around the facility.

Isolation area: Is in the Director's office

****************************** Page 1 of 3 *********************************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2024
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 9
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: ECOLE BILINGUE DE BERKELEY PRESCHOOL
FACILITY NUMBER: 013410074
VISIT DATE: 04/23/2024
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
Food Service: The school provides two snacks for the children and lunch is brought from home. LPA observed the snack menus posted. In the event a child forgets their lunch, or does not have enough, the facility will provide a hot lunch from their hot lunch program.

Records: The fire/disaster drill log was complete with the last drill logged March 11, 2024. A physical census of the children was taken and cross referenced with the electronic sign-in and out log. All staff have obtained a criminal record clearance. LPA reviewed twelve (12) children's files. All children's files were missing the "Acknowledgement of Receipt of Licensing Reports" (LIC9224) for the Type A citation dated April 3, 2024. LPA reviewed 11 staff files and found 10 of the 11 files were incomplete - 6 files were missing the Health Screening (LIC501), 4 files were missing a TB clearance, 9 files were missing proof of immunization, and 10 files were missing the Mandated Reporter Certificates.

Parent Board: The parent board was inspected to ensure all required postings are posted. LPA observed the Emergency Disaster Plan needs to be updated with the designated person for the "Direct Evacuation and Person Count" and an additional "Temporary Relocation Site" is missing. The Complaint Investigation Report dated April 3, 2024 was not posted on the parent board.

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone or fax. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

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.

******************************** Page 2 of 3 ********************************

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024
LIC809 (FAS) - (06/04)
Page: 2 of 9
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: ECOLE BILINGUE DE BERKELEY PRESCHOOL
FACILITY NUMBER: 013410074
VISIT DATE: 04/23/2024
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
Director Burnett 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.

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 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. CCC COMPLETED SAMPLING BUT THE TEST RESULTS ARE NOT YET AVAILABLE

LPA referred Director Burnett to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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/.



Director Burnett 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.

There were two (2) citations and one (1) civil penalty issued during this inspection. See LIC809-D for the Type B deficiencies.

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

Exit interview conducted and report was reviewed with the Director Chauncey Burnett.

************************************** End of Report ***********************************

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024
LIC809 (FAS) - (06/04)
Page: 3 of 9
Document Has Been Signed on 04/23/2024 03:41 PM - It Cannot Be Edited


Created By: Indira Loza On 04/23/2024 at 12:27 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: ECOLE BILINGUE DE BERKELEY PRESCHOOL
FACILITY NUMBER: 013410074

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8596(a)(1)(c)
(a)(1) Each licensed child day care facility shall post a copy of any licensing report pertaining to the facility that documents either a facility visit or a complaint investigation that results in a citation for a violation that, if not corrected, will create a direct and immediate risk to the health, safety, or personal rights of children in care. The licensing report provided by the department shall be posted immediately upon receipt, ... on, or immediately adjacent to, the interior side of the main door to the facility and shall remain posted for 30 consecutive days. (c) (3) The licensee shall require each recipient of the licensing report described in paragraph (1) pertaining to a complaint investigation to sign a statement indicating that he or she has received the document and the date it was received. This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above as the Licensing report dated 4/3/24 was not posted next to the Notice of Site Visit. Also, the children's files did not have the receipts of the Acknowlegment of Receipt of Licensing Reports (LIC9224) which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/07/2024
Plan of Correction
1
2
3
4
The Director shall post the Complaint Investigation Report dated 4/3/24 and leave the report posted for one (1) month. A picture of the report shall be emailed to the LPA. The Director shall also provide a copy of the report to all parents and have all parents sign the LIC9224. The signed reports for all children shall be emailed to LPA no later than May 7, 2024.

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: 04/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024


LIC809 (FAS) - (06/04)
Page: 8 of 9
Document Has Been Signed on 04/23/2024 03:41 PM - It Cannot Be Edited


Created By: Indira Loza On 04/23/2024 at 02:47 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: ECOLE BILINGUE DE BERKELEY PRESCHOOL
FACILITY NUMBER: 013410074

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101217(a)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:

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 10 of 11 files were incomplete which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/23/2024
Plan of Correction
1
2
3
4
The Director shall ensure all personnell files are complete and send the complete file of each staff to the LPA no later than May 23, 2024/
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: 04/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024


LIC809 (FAS) - (06/04)
Page: 9 of 9