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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013415253
Report Date: 03/07/2024
Date Signed: 03/07/2024 02:00:10 PM

Document Has Been Signed on 03/07/2024 02:00 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:DAVIS STREET COMMUNITY CENTERFACILITY NUMBER:
013415253
ADMINISTRATOR:MURILLO, TRISHFACILITY TYPE:
840
ADDRESS:951 DOWLING BOULEVARDTELEPHONE:
(510) 777-9317
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY: 60TOTAL ENROLLED CHILDREN: 40CENSUS: 0DATE:
03/07/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Daisy Amezcua- Director of Child Development CentersTIME COMPLETED:
02:15 PM
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On March 7, 2024, License Program Analyst (LPA) Briana Plumboy arrived unannounced to conduct an inspection for health and safety. LPA met with the Director of Child Development Centers, Daisy Amezcua. Present for the inspection was 2 teachers, no children were in care during the inspection due the inspection being during school hours. The hours of operation are Monday to Friday 7AM to 6PM.

The facility is located in a portable building (F01-F01A) located in the back of Roosevelt Elementary nearest Dutton Avenue. The portable has two separate classrooms; a small kitchenette with two sinks with a microwave and toaster over; and a staff office. There are separate boys and girls bathrooms with two toilets and a sink in each one and a separate all-gender bathroom for staff. There are cubbies available for all children's personal possessions. All hazardous materials and toxins would be inaccessible to children in care during today's inspection.

The outdoor play area is shared with the elementary school. A waiver is in place to ensure a schedule is maintained to prevent the children from co-mingling and children are supervised by facility staff to ensure this. All play equipment is in safe condition and free from sharp, loose or pointed parts and the areas around or under high climbing equipment has appropriate cushioned material that absorbs a fall during today's inspection. There are no bodies of water which could be accessible to children in care during today's inspection.

All required posted documents were present and posted. Disaster/fire drills are conducted by the main school, the last drill was completed on 1/29/24. All toilets, hand washing and cleaning areas are in safe and sanitary operating condition. All surfaces accessible to children are clean and toxic free during today's inspection. The sign in/out sheets were reviewed. The snack menu is posted and visible for review. All food/snacks were within expiration date.

See 809-C for continuance

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: DAVIS STREET COMMUNITY CENTER
FACILITY NUMBER: 013415253
VISIT DATE: 03/07/2024
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The facility is open in the morning for children before they attend their regular schooling and also open in the afternoon for an afterschool program. The facility is clean and well organized with age appropriate furnishings and equipment in good repair during today's inspection. There are solid waste trash cans in both rooms with tight fitting lids and cubbies for children to store their belongings. Both classrooms have first aid kits hanging in backpacks on the wall near the exit door. The facility has fully charged 3A40BC fire extinguishers. Smoke alarm system is built into the classroom and managed by the school district. Carbon monoxide detector is located in the kitchen.

Site 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.

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 Family Child Care Homes Section 102417. 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

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

Exit interview conducted and report was reviewed with the Director of Child Development Centers, Daisy Amezcua.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024
LIC809 (FAS) - (06/04)
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