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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013412308
Report Date: 02/07/2024
Date Signed: 02/07/2024 01:27:18 PM

Document Has Been Signed on 02/07/2024 01:27 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:S.S.U.C. - FOOTHILL SQUARE CHILD CENTERFACILITY NUMBER:
013412308
ADMINISTRATOR:GLORIA SPANN-LESLIEFACILITY TYPE:
850
ADDRESS:10700 MACARTHUR BLVD # 10TELEPHONE:
(510) 553-9926
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 70TOTAL ENROLLED CHILDREN: 32CENSUS: 26DATE:
02/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Sumira ThapaTIME COMPLETED:
01:30 PM
NARRATIVE
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On 02/07/2024 at 11:10 AM, Licensing Program Analysts (LPAs) Christina Watts, Ashley Curry and Ashley Akinleye conducted an Case Management - Incident at S.S.U.C - Foothill Square Child Center. LPAs met with Director, Sumira Thapa and explained the purpose of today's visit. During today's inspection, there was 26 preschool aged children in care with 4 teachers in two classrooms. Director stated there 32 preschool aged children enrolled. All staff caring and supervising children have Criminal Record Clearance.

LPA was following up on a self reported incident submitted to licensing on 02/02/2024. Facility has reported an unusual incident to licensing however the Director did not inform incident to parents/authorized representative. Per California Code of Regulations, the facility is required to inform the child's parent or authorized representative of any incident that occur in the facility. Based on the informing given, the facility in is violation of California Code of Regulations, Title 22.

LPA Christina Watts informed Director, Sumira Thapa that this report dated 02/07/2024 documents a Type B citation. Type B citation(s) are a potential risk(s) to the health, safety, or personal rights of children in care. Deficiency is being cited on LIC 809-D

Exit interview conducted and report was reviewed with the Director, Sumira Thapa. A Notice of Site Visit was given and must remain posted for 30 consecutive days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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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Document Has Been Signed on 02/07/2024 01:27 PM - It Cannot Be Edited


Created By: Christina Watts On 02/07/2024 at 12:56 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: S.S.U.C. - FOOTHILL SQUARE CHILD CENTER
FACILITY NUMBER: 013412308

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/16/2024
Section Cited
CCR
101212(f)

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101212 Reporting Requirement (f)The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative. This requirement has not been met as evidenced by:
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By COB 02/16/2024, Director stated they will submit documention on how facility will come back into compliance. Facility informed parent of incident today 02/07/2024. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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Based interviews, the licensee did not comply with the section cited above when facility did not inform parent or authorized representative of an incident that occured in the facility which poses an potential risk to the health, safety or personal rights of children in care.
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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:Sherelle Johnson
LICENSING EVALUATOR NAME:Christina Watts
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024


LIC809 (FAS) - (06/04)
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