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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422004
Report Date: 06/23/2022
Date Signed: 06/23/2022 01:26:46 PM

Document Has Been Signed on 06/23/2022 01:26 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:OUSD - ARROYO VIEJO CDCFACILITY NUMBER:
013422004
ADMINISTRATOR:JOY FORTE`FACILITY TYPE:
850
ADDRESS:1895 - 78TH AVETELEPHONE:
(510) 636-1254
CITY:OAKLANDSTATE: CAZIP CODE:
94621
CAPACITY: 72TOTAL ENROLLED CHILDREN: 40CENSUS: 18DATE:
06/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Lynn PfeifferTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Diana Campos met with Head Teacher Lynn Pfeiffer for an unannounced 1 year-Required Inspection. Present for this inspection were 5 staff and 18 preschool children in care. There are 3 classrooms but only 2 are in use today. OUSD has merged to an electronic Sign-in/sign-out method which was made available to LPA for review. There is a working phone. Per Head Teacher the last fire/emergency drill was conducted on 5/23/2022. Proper posting requirements were met with the exception of the Earthquake Preparedness posting which was given to the Head Teacher to post. Classroom furniture is in good condition. There are toys, books and educational supplies available. Floors were clean and safe. There is adequate heating, ventilation, and lighting. Bathroom toilets and sinks are in operable condition. Children are able to reach the sinks. There were adequate bathroom supplies. Kitchen area (including storage areas for food) was clean. No insects or pests were seen. A sample of food product was examined for freshness and expiration dates; there was adequate food for children who did not bring their own and for emergencies. Food is delivered to the facility on a weekly basis and heated at facility prior to serving. The center supplies breakfast, lunch and snacks. Menus were not posted but are available to parents via an OUSD online application that parents can access. Inside, there are sufficient storage cubbies for children's personal belongings. There is adequate napping equipment (mats). There is drinking water available at all times inside and outside the center through water dispenser and personal water bottles. Isolation area for sick children is in the parents waiting room. Administrator stated that there were no firearms on the premises. First aid kit is located in each classroom. There are Emergency earthquake supplies. Cleaning supplies are inaccessible to children, locked in a closet.

SEE 809-C FOR CONTINUANCE-------------------------------------------------------------------------
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 10
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: OUSD - ARROYO VIEJO CDC
FACILITY NUMBER: 013422004
VISIT DATE: 06/23/2022
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The outside play area is securely fenced and is safe and free of hazards. There were a variety of toys and play materials. The area around the climbing playground equipment is cushioned with material that absorbs a fall. There is an outside shaded area, and a grassy area. There is a creek that flows beside the center which is made inaccessible to children by a high fence.
A sample of children's files were reviewed and found to be complete. Staff records were not reviewed during today's inspection as they are kept off site at the School District's Record's Office. As a condition of employment OUSD conducts a background and health screening as well as verification of education and qualifying units prior to hire. Staff rest room is located inside the front hall. Head Teacher stated that at least one person trained in CPR/First Aid is always present. All individuals subject to a criminal record review have obtained clearance or a criminal record exemption from Oakland Unified School District. Discussed with the administrator: keeping outdoor play area clean and free of broken/unused furniture and activity equipment. Trimming thorny plants and maintaining out door area prior to children use.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm



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
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
LIC809 (FAS) - (06/04)
Page: 2 of 10
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: OUSD - ARROYO VIEJO CDC
FACILITY NUMBER: 013422004
VISIT DATE: 06/23/2022
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Head Teacher 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.

No deficiencies were cited today.

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

Exit interview conducted and report was reviewed with Head Teacher Lynn Pfeiffer.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
LIC809 (FAS) - (06/04)
Page: 3 of 10