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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418990
Report Date: 07/14/2023
Date Signed: 07/14/2023 02:41:29 PM

Document Has Been Signed on 07/14/2023 02:41 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:ROOM TO GROW PRESCHOOL, THEFACILITY NUMBER:
013418990
ADMINISTRATOR:TAYLOR, KRISTINFACILITY TYPE:
850
ADDRESS:5766 BROADWAY ST.TELEPHONE:
(510) 655-0300
CITY:OAKLANDSTATE: CAZIP CODE:
94618
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 13DATE:
07/14/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:TAGUINES, ALORATIME COMPLETED:
03:00 PM
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On 07/14/23 at 01:00PM Licensing Program Analyst (LPA) Nyeesha Blount conducted a unannounced Case management for Lead Testing/ exceedance at Room to Grow Preschool. LPA met with Assistant Director Taguines, Alora and explained the purpose of today's inspection.

LPA toured the facility for a health and safety check. The water fountain outside in the play yard exceeded the acceptable amount of lead allowed in a child care center. The Assistant director stated that facility has not used drinking fountain and will be permanently be ceased. the drinking fountain is currently covered up with a flower pot made inaccessible to children in care.

The following deficiency was observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Assistant Director Taguines, Alora.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2023
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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Document Has Been Signed on 07/14/2023 02:41 PM - It Cannot Be Edited


Created By: Nyeesha Blount On 07/14/2023 at 01:38 PM
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: ROOM TO GROW PRESCHOOL, THE
FACILITY NUMBER: 013418990

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/14/2023
Section Cited

101700.3

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Licensee shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care.
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The facility currently has a flower pot covering the fountain so it made inaccessible to children in care. Assistant Director stated they will permanently cease the drinking fountain. POC date of August 14, 2023.
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Based on record review the licensee did not comply with the section cited above as there was a drinking fountain outdoor had a lead exceedance, which poses a potential Health and Safety risk to persons in care.
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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:Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2023


LIC809 (FAS) - (06/04)
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