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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418151
Report Date: 08/30/2023
Date Signed: 08/30/2023 10:24:56 AM

Document Has Been Signed on 08/30/2023 10:24 AM - 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:EYES ON YOU DAY CARE CENTERFACILITY NUMBER:
013418151
ADMINISTRATOR:KING, LOLITAFACILITY TYPE:
850
ADDRESS:21753 VALLEJO ST.TELEPHONE:
(510) 581-6432
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 15DATE:
08/30/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Lolita Yates KingTIME COMPLETED:
10:30 AM
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On August 30, 2023 at 8:30 AM., Licensing Program Analyst Elimika Woods. LPA met with the facility representative and performed a physical inspection of the facility to verify the POC was cleared and the facility remained in compliance following LPA's 06/29/23 Case Management inspection visit. Today, LPA verified the following POC's were cleared:

Type B POC
101700.3(b)(1)-Lead Testing Written Directive- A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance (ALE). The department was notified that one (1) water fountain located on the outside of exterior building have elevated lead levels that have exceeded 5.5 ppb.

LPA Woods verified the drinking fountain was capped and faucet was removed.

LPA discussed this report with the facility representative Lolita Yates-King. A copy of POC letters were issued.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2023
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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