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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417503
Report Date: 06/02/2023
Date Signed: 06/02/2023 03:23:17 PM

Document Has Been Signed on 06/02/2023 03:23 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:AQUATIC PARK SCHOOLFACILITY NUMBER:
013417503
ADMINISTRATOR:BAUER, ANNFACILITY TYPE:
830
ADDRESS:830 HEINZ AVENUETELEPHONE:
(510) 843-2273
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY: 19TOTAL ENROLLED CHILDREN: 19CENSUS: 9DATE:
06/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:36 AM
MET WITH:Anne BauerTIME COMPLETED:
03:35 PM
NARRATIVE
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On June 2, 2023 at approximately 8:36am, Licensing Program Analyst (LPA) Indira Loza arrived unannounced for an annual inspection and met with Director Anne Bauer. Present for the inspection were the Director, 3 teachers and 9 infant children in care. The center location has a preschool and an infant center license. The physical inspections were done simultaneously.

The Infant center is located in a separate building next to the Preschool component. The Infant room has three rooms, there were two rooms used for napping, and a large play room. The children have their own playground yard, all is in safe condition and free from sharp, loose or pointed parts. The center also has a waiver for the infants to be able to share the preschool yard when the preschoolers are not there. There is access to drinking water available and teachers are always present.



Disaster drills are conducted at least once every six months, the last drill was conducted April 21st, 2023. The facility has a 3A10BC fire extinguisher. The classrooms are well ventilated and heated.

A Changing table is available in the classroom (within arm’s length of the sink). There are enough towels and soap supplies. The staff have separate adult bathroom located in the school office. The facility is clean and well organized with ample age appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. Hazardous items/toxins are kept out of the access of children. There are no bodies of water accessible to children in care. The facility provides two snacks to the older infants. All children bring their own lunch.

The sign in/out sheets were reviewed and were accurate. Classrooms have trash cans with tight fitting cover for the disposal of solid waste. No children require any use of Incidental Medical Services (IMS). Children's records were reviewed, safe sleep logs are not maintained and therefore the children's files were found to be incomplete. See LIC809-D. Staff files were reviewed. Opening and closing staff have current CPR and first


********************************See LIC809-C for report continuance****************************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 06/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2023
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 5
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: AQUATIC PARK SCHOOL
FACILITY NUMBER: 013417503
VISIT DATE: 06/02/2023
NARRATIVE
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 aid training. All staff subjected to criminal review have been cleared and associated to the facility.
All documents required to be posted were appropriately posted on the walls: License; Emergency Disaster Plan; Notification of Parents Rights; Personal rights; Child seatbelt laws; menus; daily activity schedules.

This facility provides Incidental Medical Services – IMS, but currently no children require the IMS. For IMS information see PIN 23-02. 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

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.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

There were 4 deficiencies issued today, see LIC809-D for details.

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


Exit interview conducted and report was reviewed with Director Anne Bauer.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 06/02/2023 03:23 PM - It Cannot Be Edited


Created By: Indira Loza On 06/02/2023 at 11:46 AM
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: AQUATIC PARK SCHOOL
FACILITY NUMBER: 013417503

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/02/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.954
Licensure Requirements
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as there was no carbon monoxide detector in the facility which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
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Director shall email the LPA a picture of a working carbon monoxide detector in the facility no later than June 16, 2023.
Type B
Section Cited
CCR
101416.2(g)
Infant Care Teacher Qualifications and Duties
(g) An infant care teacher shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as no infant teachers had a Preventative Health and Safety certificate which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/28/2023
Plan of Correction
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Director shall email a copy of a current Preventative Health and Safety certificates no later than July 28, 2023.
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: 06/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/02/2023


LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 06/02/2023 03:23 PM - It Cannot Be Edited


Created By: Indira Loza On 06/02/2023 at 11:46 AM
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: AQUATIC PARK SCHOOL
FACILITY NUMBER: 013417503

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/02/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in two out of four infant teachers did not have a current Mandated Reporter Certificate which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/30/2023
Plan of Correction
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Director shall email a current Mnadated Reporter Certificate for L. Hall and M. Sanchez no later than June 30, 2023.
Type B
Section Cited
CCR
101429(a)(2)(C)
Responsibility for Providing Care and Supervision for Infants
(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above as no children's files had the infant sleep logs in their files, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
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The Director shall email the LPA a copy of five days worth of infant sleep logs, no later than June 16, 2023.
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: 06/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/02/2023


LIC809 (FAS) - (06/04)
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