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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420579
Report Date: 03/23/2022
Date Signed: 03/23/2022 06:40:19 PM

Document Has Been Signed on 03/23/2022 06:40 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:
013420579
ADMINISTRATOR:ZIMANY, RENATAFACILITY TYPE:
850
ADDRESS:12000 CAMPUS DRIVETELEPHONE:
(510) 717-8494
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY: 59TOTAL ENROLLED CHILDREN: 59CENSUS: 0DATE:
03/23/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
03:31 PM
MET WITH:Renata ZimanyTIME COMPLETED:
06:40 PM
NARRATIVE
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On March 23, 2022 Licensing Program Analysts (LPAs) Catherine Fernandes and Indira Loza met with Director Renata Zimany to conduct a Case Management visit as a result of a report made to Licensing regarding COVID positives and Exposures throughout the Preschool. LPAs Fernandes and Loza toured the preschool and saw no children in care.

Director Zimany stated that the center has been closed since Friday, March 18, 2022 due to the positive staff and children at the center.

LPA Fernandes informed Director Zimany that there was no report received in the Oakland Regional Office about the COVID Positives or the school closure.

The attached Type B deficiency is being cited today and must be corrected by the due date.


An exit interview was conducted and the report was discussed with the Director
Report and Appeal Rights provided
A SITE VISIT NOTICE WAS POSTED.

See 809D.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2022
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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Document Has Been Signed on 03/23/2022 06:40 PM - It Cannot Be Edited


Created By: Catherine Fernandes On 03/23/2022 at 04:39 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: 013420579

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/15/2022
Section Cited
CCR
101212(d)(1)(E)

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Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. This requirement has not been met as evidenced by:
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Director is to review Reporting Requirement Regulations and write what she understood from the reading and send a copy to CCL by proof of correction date.
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Based on interviews the Director confirmed she was unaware she had to report COVID positives to Licensing, which can be a potential risk to children 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:Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2022


LIC809 (FAS) - (06/04)
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