<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422012
Report Date: 05/15/2024
Date Signed: 05/15/2024 03:17:30 PM

Document Has Been Signed on 05/15/2024 03:17 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:AB'S PRESCHOOL AND DAYCAREFACILITY NUMBER:
013422012
ADMINISTRATOR/
DIRECTOR:		AYALEW, MERATFACILITY TYPE:
850
ADDRESS:301 DOWLING BLVDTELEPHONE:
(510) 564-4276
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 6DATE:
05/15/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Faye TomsTIME VISIT/
INSPECTION COMPLETED:
03:30 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 05/15/2024 at 9:40AM, Licensing Program Analysts (LPAs) Jaleesa Jackson and Manel Estoesta conducted an Unannounced Plan of Correction visit to the facility and met with facility representative Faye Toms. Also present at the time of the visit were 6 preschool aged children and 1 aide. The Director Merat Ayalew was not present during the visit. Office Assistant Donna Jefferson arrived at the facility at 11:45AM.

LPAs observed several overgrown weeds throughout the outdoor play space for the preschool children and advised that they need to be removed. LPA Jackson observed 1 child not signed in correctly in the sign in and out sheet.

At 11:45AM S1 arrived at the facility and their criminal record clearance had not been transferred from another facility.

On 05/01/2024, LPA conducted a case management visit. The Child Care Center was cited 1 Type A citation for Ratio.

The Licensee and LPA developed a Plan of Correction (POC) with submission due date of 05/02/2024 and LPA conducted a POC visit.

LPA generated a Letter of Deficiency Citations Cleared and provided a copy to the Facility Representative.

There were 3 deficiencies cited on today's visit. See 809-D for deficiencies.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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 4
Document Has Been Signed on 05/15/2024 03:17 PM - It Cannot Be Edited


Created By: Jaleesa Jackson On 05/15/2024 at 11:37 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: AB'S PRESCHOOL AND DAYCARE
FACILITY NUMBER: 013422012

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/22/2024
Section Cited
CCR
101238.2(d)(2)

1
2
3
4
5
6
7
The surface of the outdoor activity space shall be maintained: Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee will have all the weeds removed from the outdoor play space.
8
9
10
11
12
13
14
Based on observations, the outdoor play space is surrounded by weeds that need to be removed, which is a potential health and safety risk to persons in care.
8
9
10
11
12
13
14
Type B
05/22/2024
Section Cited
CCR101229.1(a)(1)

1
2
3
4
5
6
7
In addition to the sign-in procedure requirement... the licensee shall develop, maintain, and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.
1
2
3
4
5
6
7
Director will submit a written statement on how the facility will ensure the sign in and out will be implemented moving forward. Statement will be signed and dated by POC date to LPA by email. Licensee will send out a newsletter about sign in and out proceedure to parents and send a copy to LPA.
8
9
10
11
12
13
14
Based on record review, 1 out of 6 children were not signed in properly, which is a potential health and safety risk to persons in care.
8
9
10
11
12
13
14
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:Jason Jang
LICENSING EVALUATOR NAME:Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2024


LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 05/15/2024 03:17 PM - It Cannot Be Edited


Created By: Jaleesa Jackson On 05/15/2024 at 01:40 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: AB'S PRESCHOOL AND DAYCARE
FACILITY NUMBER: 013422012

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/16/2024
Section Cited
CCR
101170(e)(2)

1
2
3
4
5
6
7
All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 101170(f)...
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee will submit an LIC9182 to the Oakland Regional Office to transfer A1's clearance to both licenses at this facility.
8
9
10
11
12
13
14
Based on record review, S1 was present at the facility without transferring her existing criminal record clearance, which is an immediate health and safety risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Jason Jang
LICENSING EVALUATOR NAME:Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2024


LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: AB'S PRESCHOOL AND DAYCARE
FACILITY NUMBER: 013422012
VISIT DATE: 05/15/2024
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
26
27
28
29
30
31
32
LPA Jackson informed Facility Representative that this report dated 5/15/2024 document 1 Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Jackson informed the Director to provide a copy of this licensing report dated 5/15/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Exit interview conducted and report was reviewed with the Facility Representative Donna Jefferson.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4