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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420526
Report Date: 06/26/2024
Date Signed: 06/26/2024 06:06:18 PM

Document Has Been Signed on 06/26/2024 06:06 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LI'L ANGELS CENTER FOR EARLY EDUCATIONFACILITY NUMBER:
013420526
ADMINISTRATOR/
DIRECTOR:		YAKKELING ESQUIVELFACILITY TYPE:
850
ADDRESS:890 FARGO AVETELEPHONE:
(510) 895-8736
CITY:SAN LEANDROSTATE: CAZIP CODE:
94579
CAPACITY: 59TOTAL ENROLLED CHILDREN: 59CENSUS: 26DATE:
06/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Yakkeling EsquivelTIME VISIT/
INSPECTION COMPLETED:
06:20 PM
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On June 26, 2024 at 2:15 PM., Licensing Program Analysts (LPAs) Lorraine Dacanay Breaux and Jialing Zhu an unannounced 1 Year Required Inspection and met with the facility representative, Yakkeling Esquivel. LPA disclosed the purpose of the inspection and was granted entry into the facility. Director was provided LIC 125. There were twenty-six (26) children present during this inspection and three additional staff members. The facility is located on the grounds of a church and was toured for a health and safety inspection inside and outside. The hours of operation are 6:30 AM - 6:00 PM Monday -Friday. This facility has an infant component # 01340527.

CLASSROOMS: At 2:30 PM, LPAs toured and teacher child ratio was observed. There are two classrooms for the preschool. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. The isolation area for sick children is in the classroom away from the children, until parents pick up. Drinking water is available inside and outside of the center. There were 4 fully charged 2A10BC fire extinguisher, a functioning carbon monoxide detector, wired smoke detectors, sprinkler system, and a pull down fire alarm.

FOOD SERVICE AREAS: This facility provides lunch, and snacks for children in care. The menu is posted on the board and available for parents to view on the Pro Care app. LPA observed an area where they have a refrigerator this area is clean and free of evidence of rodents. Director is reminded to label all foods with the expiration date. Low-fat 1% milk is being served at this facility and pesticides and other similar toxic substances are not stored in cabinets that contains food. All storage containers for solid waste have tight fitting covers that are in good repair.

OUTDOOR PLAY AREAS: There's a play structure with a slide and two swings that has cushioning to absorb falls that is anchored. There are large trees that provides shade to children while at play. The playground is fully fenced and sits on the grounds of the church. There's a shed that contains equipment that has a lock on the playground which is inaccessible to children.

See 809-C
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LI'L ANGELS CENTER FOR EARLY EDUCATION
FACILITY NUMBER: 013420526
VISIT DATE: 06/26/2024
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BATHROOMS AND TOILETING AREAS: The staff's bathroom is separate from the children's bathroom. All sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets. Supplies are available to the children.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Four (4) children's files and two (2) staff files were reviewed around 3:30 PM. All staff files have required Health Screening, Employee Rights, and Criminal Record Statements and all children files contain Identification & Emergency, Parent Rights and Medical Consent forms. Facility uses their own forms. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed, and certificates were reviewed. The facility representative's CPR and First Aid certificate is current and expires on 11/11/2024. The center is in compliance with the sign in and out procedure ProCare App. Disaster drills are being conducted at least once every 6 months and the last one conducted was on 02/15/2024. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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: https://www.ada.gov/resources/child-care-centers/.

Per director the facility is not administering medication at this time.

California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

See 809-C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LI'L ANGELS CENTER FOR EARLY EDUCATION
FACILITY NUMBER: 013420526
VISIT DATE: 06/26/2024
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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.

Facility representative 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.

MyChildCarePlan.org: Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Please see list below and attached pages for information on deficiencies and advisory notes issued today:



TYPE B Violations: One Staff file and one volunteer files was not available for LPAs to review.

LPA discussed and Director was provided LIC 308 and LIC 9227 forms.

See 809-d for deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the director, Yakkeling Esquivel.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/26/2024 06:06 PM - It Cannot Be Edited


Created By: Lorraine Dacanay-Breaux On 06/26/2024 at 05:27 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: LI'L ANGELS CENTER FOR EARLY EDUCATION
FACILITY NUMBER: 013420526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101217(d)
Personnel Records
(d) All personnel records shall be maintained at the child care center and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, record review, the licensee did not comply with the section cited above, staff files not available for LPAs to review which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/12/2024
Plan of Correction
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1) Director will write a statement on how moving forward she will ensure that all staff and voluteers files are update and ready for licensing to review.
2) Director will complete the files for the two staff and provide a copies of all required forms to LPA via email by July 12, 2024 via email Lorraine.Dacanay-Breaux@dss.ca.gov
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Chandra Charles
LICENSING EVALUATOR NAME:Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:
DATE: 06/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/26/2024


LIC809 (FAS) - (06/04)
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