013420528-5-5-2022-02-CC-DCAS-CE5TYG-20220505150842

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013420528
Report Date: 05/05/2022
Date Signed: 05/05/2022 03:09:02 PM

Document Has Been Signed on 05/05/2022 03:09 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:	DR. HERBERT GUICE CHRISTIAN ACADEMY		FACILITY NUMBER:	013420528
ADMINISTRATOR:	ANGELA DARBY		FACILITY TYPE:	850
ADDRESS:	6925 INTERNATIONAL BLVD		TELEPHONE:	(510) 729-0330
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94621
CAPACITY: 57	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	05/05/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Angela Darby		TIME COMPLETED:	03:20 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 05/05/2022 at 9:30am Licensing Program Analyst (LPA) Diana Campos arrived at the facility to conduct an unannounced Required 1 year inspection. LPA met with Director Angela Darby. There were 5 staff and 10 preschoolers present during the inspection. The toilets and sinks were in operable condition. The floors were free of tripping hazards. All storage containers for solid waste have tight-fitting covers that are in good repair. Drinking water is available both indoors and outdoors. Menus are posted and visible for parents to review. Outdoor activity space and playground equipment was observed to be safe with appropriate cushioning material to absorb falls. The facility is operating within its licensed capacity. The facility is within ratio today with one teacher supervising no more than 12 children. LPA did not observe any child left without visual supervision or unattended during the inspection. LPA verified both opening and closing staff have current CPR/First aid training. A physical census was taken of all children present and crossed referenced with the sign in and out sheets. A sample of children’s records were reviewed. Files reviewed contained emergency information and health assessments. Staff records reviewed have required health screening. Fire/Disaster drill are conducted at least every six months and the last fire drill was conducted 4/2022. The director understands that prior to working or volunteering in a licensed child care facility, all individuals subject to criminal record review shall obtain a clearance or criminal record exemption. This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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: http://www.ada.gov/childqanda.htm --------------------See LIC809C for continuation----------------------------------------------------------

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: DR. HERBERT GUICE CHRISTIAN ACADEMY	FACILITY NUMBER: 013420528
	VISIT DATE: 05/05/2022

NARRATIVE

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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

Center Director Angela Darby 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.

LPA discussed the safe sleep regulations with Center Director Angela Darby 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 center Director Angela Darby 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Center Director Angela Darby.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

LIC809 (FAS) - (06/04)

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