<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418198
Report Date: 05/05/2021
Date Signed: 05/05/2021 03:23:16 PM

Document Has Been Signed on 05/05/2021 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:JEWISH COMMUNITY CTR OF THE EAST BAY-BERKELEYFACILITY NUMBER:
013418198
ADMINISTRATOR:SHORER, RUTHFACILITY TYPE:
850
ADDRESS:1414 WALNUT STREETTELEPHONE:
(510) 848-0237
CITY:BERKELEYSTATE: CAZIP CODE:
94709
CAPACITY: 75TOTAL ENROLLED CHILDREN: 0CENSUS: 34DATE:
05/05/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Director Ruth ShorerTIME COMPLETED:
03:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 05/05/2021, Licensing Program Analyst (LPA) Brittany Newton conducted an unannounced case management inspection for the purpose of following up on an Incident Report received in our office on 04/26/2021.

An incident occurred that was a violation of a child's personal rights.

Interviews conducted revealed that a child had been hit multiple times, forced to sit in their cubby on multiple occasions, and spoken to in an inappropriate manner by teachers.

The attached type A deficiency is cited today and must be corrected by the due date. Upon receipt, licensee shall post this report for 30 days at the facility. Additionally, facility must provide copies of this licensing report to parent/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A signed LIC 9224 must be placed in each child's file to acknowledge receipt of report.

Facility will be scheduled for a Non-Compliance Conference in relation to this incident.

Exit interview conducted, appeal rights provided, and a copy of this report was left with the Director.




SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Brittany Newton
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2021
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 2
Document Has Been Signed on 05/05/2021 03:23 PM - It Cannot Be Edited


Created By: Brittany Newton On 05/05/2021 at 11:58 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: JEWISH COMMUNITY CTR OF THE EAST BAY-BERKELEY
FACILITY NUMBER: 013418198

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/05/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
05/06/2021
Section Cited
CCR
101223(a)(3)

1
2
3
4
5
6
7
101223(a)(3) Personal Rights. The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Facility agrees to provide training to all staff regarding personal rights and positive reinforcement in the classroom. Facility will additionally develop a Code of Conduct contract for all staff. Facility will submit the training plan to LPA Newton by 05/06/2021. Once training has been complete, facility will send list of staff signatures.
8
9
10
11
12
13
14
Based on interviews conducted, a child in care has been hit multiple times by a teacher, forced to sit in their cubby, and had been spoken to in an inappropripate manner which poses an immediate Health, Safety, or Personal Rights risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Brittany Newton
LICENSING EVALUATOR SIGNATURE:
DATE: 05/05/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/05/2021


LIC809 (FAS) - (06/04)
Page: 2 of 2