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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013414731
Report Date: 01/07/2025
Date Signed: 01/07/2025 01:20:23 PM

Document Has Been Signed on 01/07/2025 01:20 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:CAPE - JACKSON CENTERFACILITY NUMBER:
013414731
ADMINISTRATOR/
DIRECTOR:		MARIA MEDINAFACILITY TYPE:
850
ADDRESS:560 JACKSON AVENUETELEPHONE:
(925) 455-7270
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 23DATE:
01/07/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Celia CervantesTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 1/7/2025 at 9:10AM Licensing Program Analyst (LPA) Jaleesa Jackson met with Director Celia Cervantes for an Unannounced Annual/Random Visit. There were 6 fingerprint cleared staff, 16 preschool aged children, and 7 toddlers present during today's inspection. The facility operates on the far-right side of the Jackson Avenue Elementary School campus. Two classrooms were toured for a health and safety inspection. The facility has a toddler program that is separate from the preschool. The facility operates from 8:00AM – 5:00PM, Monday – Friday.

The facility has age-appropriate materials in the classroom that were observed to be clean and in good condition. During today's visit all toxins, cleaning products, children’s medication, and hazardous materials were observed to be in inaccessible areas. The children's sink and toilet are observed to be clean and in proper working order. There is a separate staff bathroom on site as well. There is a fully charged fire extinguisher, carbon monoxide detector, and smoke detectors in each classroom. Facility does not transport children.

The food prep area is clean, well maintained, and free from defects. Facility provides breakfast and snacks to the children. The lunch is provided by Valley Care Hospital. All children have access to clean drinking water in the classrooms and the outdoor play yard.

Both of the outside play yards are clean with age-appropriate materials for the children. Outdoor activity space and playground equipment observed to be safe and free of hazards. Climbing equipment is properly anchored to the ground with appropriate cushioning material to absorb falls. The facility has sandboxes that are covered when not in use. The facility has the preschool and toddler playgrounds separate. There is a shaded area provided for the children. LPA did not observe any harmful or unattended bodies of water in or around the facility.
Continued 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAPE - JACKSON CENTER
FACILITY NUMBER: 013414731
VISIT DATE: 01/07/2025
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LPA reviewed 5 children's files and 7 staff files. At least one opening/closing staff member has a current CPR & First Aid Certificate. All staff have current Mandated Reporter Training. The facility uses an app called Child Plus for the children’s parents and authorized representatives to sign the children in and out of the facility. All children were properly signed into the facility. The facility conducts and documents disaster drills at least every 6 months. The last drill was documented 12/5/2024. All required postings are posted by the entrance of the facility.

There were no deficiencies cited during today's visit.

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.

Facility representative 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.

Continued on 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2025
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAPE - JACKSON CENTER
FACILITY NUMBER: 013414731
VISIT DATE: 01/07/2025
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LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated 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) 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/.

Facility representative 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.

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

Exit interview conducted and report was reviewed with the facility representative Celia Cervantes.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2025
LIC809 (FAS) - (06/04)
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