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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419485
Report Date: 03/25/2022
Date Signed: 03/25/2022 05:16:07 PM

Document Has Been Signed on 03/25/2022 05:16 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:TUDORKA TOTS INFANT AND PRESCHOOL CENTERFACILITY NUMBER:
013419485
ADMINISTRATOR:ZIMANY, RENATAFACILITY TYPE:
830
ADDRESS:12000 CAMPUS DRIVETELEPHONE:
(510) 531-2223
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 15DATE:
03/25/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:ZIMANY, RENATATIME COMPLETED:
05:27 PM
NARRATIVE
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On 3/25/22, at 10:15AM, Licensing Program Analysts (LPAs) Catherine Fernandes and Indira Loza met with Director/Owner Renata Zimany for an unannounced continuation inspection. The infant center was inspected to conduct a health and safety check. Present during the inspection were 14 infants and five additional finger print cleared staff members. The teacher/child ratio was being met today. There is a preschool component on the property with facility number 013420579 located on the lower floor. This center operates Monday through Friday 7:30AM to 5:30PM.
The day care operates out of the East Hills church and has three rooms on the top floor right side of the building. The nap room is located on the far right side of the day care and has five cribs. The furniture, equipment and activities appear to be age appropriate for the children in care. The heating and lighting is adequate. LPA Fernandes and Loza observed bottled waters available for the infants. The changing table is within arms reach of the sink. There is a swimming pool on the property that is fenced and belongs to the church. LPAs did not observe cleaning supplies or toxic items accessible to children during todays inspection. Lunches and snacks are brought from home. The outside play area is located on the same floor but it not being used, instead the day care is using the patio area, which is fenced in. LPAs observed a shaded area and age appropriate toys, that appear to in good repair. All required documents are posted for public review. Disaster drills are being conducted at least once every 6 months, the last drill was recorded on 1/18/22. The center is equipped with a fully stocked first aid kit, working cell phone, carbon monoxide detector located in the entrance area, a pull down fire alarm was observed and a 3A40BC fire extinguisher in the first room. The fire system is hardwired. A review of 11 infants records and six staff files were reviewed.
The following items have been cited during the inspection:
- During file reviews LPAs observed missing required documents for staff and infants.
- No infant sleep plans were observed and Director stated she was unaware of the requirement to have them.
- No roster was available to verify enrolled and present infants, Director confirmed she did have one and thought the Bright Wheel app was tracking that.
Report continued on 809C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/25/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 3 of 15
Document Has Been Signed on 03/25/2022 05:16 PM - It Cannot Be Edited


Created By: Indira Loza On 03/25/2022 at 11:55 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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(e)(4)
Fixtures, Furniture, Equipment and Supplies
(4) All toilets, handwashing and bathing facilities shall be maintained in safe and sanitary operating condition. Additional equipment, aids and/or conveniences shall be provided as needed in centers that serve children with physical disabilities.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the sink in the bathroom was clogged, the Director did not comply with the section cited above, which poses potential health risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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The center need to repair the bathroom sink in the main classroom and send proof of the correction to CCL of proof of correction date.
Type B
Section Cited
CCR
101439(h)(5)
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(h) Infant changing tables shall: (h) Infant changing tables shall: (5) Not be located in the kitchen/food-preparation area.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation there were infants bottles place by the changing table next to the sink, the Director did not comply with the section cited above which posed a potential health and safety risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director will come up with a plan to ensure bottles are not place near or next to the changing table. Then send the plan to CCL by proof of correction date.
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: 03/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022


LIC809 (FAS) - (06/04)
Page: 3 of 13
Document Has Been Signed on 03/25/2022 05:16 PM - It Cannot Be Edited


Created By: Indira Loza On 03/25/2022 at 11:55 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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101430(a)(3)(B)
Infant Care Activities
(B) No infant shall be forced to sleep, to stay awake or to stay in the designated sleeping area.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations an infant cried themselves to sleep, the Director did not comply with the section cited above, which poses a personal rights risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director will come up with a plan to ensure the child's personal rights are not violated and send a copy to CCL by proof of correction date.
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 only one staff member had a current mandated reporter training on file, the Director did not comply with the section cited above in five out of six files reviewed, which poses/posed a potential health and safety risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director will have all staff members complete Mandated Reporter training by 4/18/22 and send a list of what staff members completed the training to CCL by proof of correction date.
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: 03/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022


LIC809 (FAS) - (06/04)
Page: 4 of 13
Document Has Been Signed on 03/25/2022 05:16 PM - It Cannot Be Edited


Created By: Indira Loza On 03/25/2022 at 11:55 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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review staff members did not have current or correct CPR, the Director did not comply with the section cited above six out of six staff, which posed a potential safety risk to persons in care.
POC Due Date: 04/25/2022
Plan of Correction
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Director needs to provide date for trainig and send a copy by proof of correction date.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review staff 5 is missing a TB test, the Director did not comply with the section cited above one out of six staff files, which poses a potential health risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director will send proof of a TB test for staff 5 to CCL by proof of correction date.
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: 03/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022


LIC809 (FAS) - (06/04)
Page: 5 of 13
Document Has Been Signed on 03/25/2022 05:16 PM - It Cannot Be Edited


Created By: Indira Loza On 03/25/2022 at 11:55 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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.2(a)
Infant Needs and Services Plan
(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review two infants did not have a needs and service plan, the Director did not comply with the section cited above in two out of six infant files, which poses a potential health risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director will conduct an audit of all files and to ensure all infants have a needs and service plan. Director will come up with a plan to ensure all needs and services are completed prior to the first day of care and send a copy to CCL by proof of correction date.
Type B
Section Cited
CCR
101419.3(a)
Modifications to Infant Needs and Services Plan
(a) The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review one infant did not have a current needs and service plan ,the Director did not comply with the section cited above in one out of six files reviewed, which poses a potential health risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director will conduct an audit of all files and update all needs and service plans. Director will come up with a plan to ensure all needs and services stay current and send a copy to CCL by proof of correction date.
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: 03/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022


LIC809 (FAS) - (06/04)
Page: 4 of 15
Document Has Been Signed on 03/25/2022 05:16 PM - It Cannot Be Edited


Created By: Indira Loza On 03/25/2022 at 11:55 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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101427(b)
Infant Care Food Services
(b) There shall be an individual feeding plan for each infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record reviews no infant feeding plan was observed, the Director did not comply with the section cited above in 11 out of 11 files, which poses a potential health risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director shall review regulations regarding individual feeding plan for infants and come up with a form. Then send a copy to CCL by proof of correction date.
Type B
Section Cited
HSC
1596.8595(c)(2)
Upon enrollment of a new child in a facility, the licensee shall provide to the parents or legal guardians of the newly enrolling child copies of any licensing report that the licensee has received during the prior 12-month period that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review LIC9224 was not placed in children's files, the Director did not comply with the section cited above 11 out of 11 files were reviewed, which poses a potential health and safety risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director shall provide all parents from dates 1/15/21 to 1/15/22 a copy of the licensing report dated 1/15/21 and ensure signed LIC9224 is placed in each child's file. Then come with a plan to ensure the health and safety code is being met to CCL by proof of correction date.
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: 03/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022


LIC809 (FAS) - (06/04)
Page: 7 of 13
Document Has Been Signed on 03/25/2022 05:16 PM - It Cannot Be Edited


Created By: Indira Loza On 03/25/2022 at 02:18 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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(d)
The sign-in and sign-out sheets with the signatures required by this section and by Section 101226.1 shall be kept for one month and shall be available at the center for review by the Department.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observations and conformation form the Director there is no written way to verify sign in or sign out, the Director did not comply with the section cited above, which poses a potential safety risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director shall come with a way to print out or write up sign in or sign out logs for all children. Then send the plan to CCL by proof of correction date.
Type B
Section Cited
CCR
101427(J)
Infant Care Food Service Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations baby food pouches and a container of formula was not labeled or dated, the Director did not comply with the section cited above, which poses a potential health and safety risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director will label and date all food items, and come up with a plan to ensure all items brought from home meet regulation standards. Then send the plan to CCL by proof of correction date.
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: 03/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022


LIC809 (FAS) - (06/04)
Page: 9 of 13
Document Has Been Signed on 03/25/2022 05:16 PM - It Cannot Be Edited


Created By: Indira Loza On 03/25/2022 at 02:30 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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review six staff members do not have current influenza vaccinations and staff 6 does not have any vaccinations on file, the Director did not comply with the section cited above in six out of six which poses a potential health, risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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Director will obtain an immunization records for staff 6 and get current influenza vaccinations from all staff members for 2022. Then send a statement of competition to CCL by proof of correction date.
Type B
Section Cited
HSC
1596.841
Current roster of children provided care in facility required: Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on conformation from the Director there is no current roster due to the use of the Bright Wheel app, the Director did not comply with the section cited above, which poses a potential safety risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
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2
3
4
Director shall send in a current roster reflecting the current status of the day care by proof of correction date.
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: 03/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022


LIC809 (FAS) - (06/04)
Page: 5 of 15
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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485
VISIT DATE: 03/25/2022
NARRATIVE
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- No way to review sign in and sign out sheets
- Files were missing the details needed in the Infant Feeding plan
- Files that were reviewed were missing LIC9224
- LPAs did not observe a sleep log. Director stated that Bright Wheel tracks sleeping however the bright wheel checks are every 30 minutes and no signatures are required.
- LPAs asked the Director for a written plan to ensure indoor and outdoor activities, Director stated she does not have one and goes off of the needs of the infant.
- No current staff member has an approved EMSA CPR certificate
- One of the five staff member had a current Mandated Reporter Training
- Three out of the six infants under 12 months had a current Needs and Service plan
- LPAs observed baby food pouches and jars with no labels or dates mixed in with labeled items, Director stated that staff was aware of what food belong to each infant.
- Observed container of powder milk with no name or date
- The changing table is next to the infants bottles that are on the sink
- The sink in the main classroom bathroom contained water and is not in working order.
- LPA Fernandes observed an infant crying themselves to sleep in the crib. Director stated that the child is being sleep trained and is following the parent's order.

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/process.

Director Zimany 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.


Report Continues on 809C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022
LIC809 (FAS) - (06/04)
Page: 12 of 13
Document Has Been Signed on 03/25/2022 05:16 PM - It Cannot Be Edited


Created By: Indira Loza On 03/25/2022 at 03:52 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: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101430(a)
Notwithstanding Section 101230, the following shall apply: The infant care center shall develop, maintain and implement a written plan to ensure the provision of indoor and outdoor activities designed to meet the needs of infants, including but not limited to: (A) Quiet and active play. (B) Rest and relaxation. (C) Eating. (D) Toileting. (E) Individual attention. (F) Being held by a caregiver.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interviews with the Director there is no planed activities, the Director did not comply with the section cited above, which poses a potential health risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
1
2
3
4
Director is to come up with a plan that meets the above stated regulation A through F and send a copy to CCL by proof of correction date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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: 03/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022


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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: TUDORKA TOTS INFANT AND PRESCHOOL CENTER
FACILITY NUMBER: 013419485
VISIT DATE: 03/25/2022
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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.

See 809D for deficiencies cited during todays inspection.

The following forms need to be submitted by 4/18/22.


Updated floor plan explaining each classroom
LIC 500 Personnel Report
Children's Roster


A notice of site visit was given and must remain posted for 30 days
Exit interview conducted and report was reviewed with the Director Renanta Zimany
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022
LIC809 (FAS) - (06/04)
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