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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422419
Report Date: 09/07/2022
Date Signed: 09/07/2022 03:20:38 PM

Document Has Been Signed on 09/07/2022 03:20 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:YMCA OF THE EAST BAY Y-KIDS PATTERSONFACILITY NUMBER:
013422419
ADMINISTRATOR:KAY, MORIAHFACILITY TYPE:
840
ADDRESS:35521 CABRILLO DR.TELEPHONE:
(925) 808-5287
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 60TOTAL ENROLLED CHILDREN: 28CENSUS: 24DATE:
09/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Moriah Walton and Jennifer Kincheloe TIME COMPLETED:
03:25 PM
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On September 7, 2022 at approximately 12:00pm, LPA Haderer arrived unannounced for an annual inspection for compliance to Health and Safety. The new CARE tool was used for the inspection. Present for the inspection was assistant site director Jennifer Kincheloe; teachers aid Vanessa La Verne and 9 children in care. The center director Moriah Walton was out briefly and arrived during visit. During the inspection, a second wave of children arrived, totaling 24 children present. The center operates from 7:00am to 8:30, then closes briefly and reopens from 11:30am to 6:00PM.

The child care center operates in a large portable room on the campus of Patterson Elementary School. The children use the school yard and playground, all is in safe condition and free from sharp, loose or pointed parts and the areas around or under high climbing equipment has appropriate cushioned material that absorbs a fall. Access to drinking water is available and teachers are always present.



The facility is clean and well organized with ample age appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. Hazardous items/toxins are kept in a cabinet in the staff restroom out of the access of children. There are no bodies of water accessible to children in care. Children bring their own food from home, the center provides snacks. There is a drinking fountain on the sink basin in the classroom and also bottled water and a water dispenser for children in the classroom.

The facility has 2 fully charged 3A40BC fire extinguishers, one mounted next to each door in the classroom. The last annual inspection was done 10/14/2021. Fremont Fire Department conducts fire inspections, the control panel reads “System all Normal.” The carbon monoxide detector was tested and functioning. Heating and ventilation in the classroom is acceptable. Disaster drills are conducted at least once every six months but were not properly documented. A Technical Violation was issued. Children use the single bathroom in the classroom and if needed, use the school bathrooms on campus. There are enough towels and soap supplies. The staff have separate adult bathroom located in the classroom.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2022
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: YMCA OF THE EAST BAY Y-KIDS PATTERSON
FACILITY NUMBER: 013422419
VISIT DATE: 09/07/2022
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The sign in/out sheets were reviewed and are accurate. Classrooms have trash cans with tight fitting cover for the disposal of solid waste.

Snacks were checked, all items were fresh and not expired,

Children's records were reviewed: LPA requested the children's facility roster and made a copy for the files. All files selected were complete and up to date.

Staff files were reviewed. Opening and closing staff have current CPR and first aid training. All staff subjected to criminal review have been cleared and associated to the facility. Some staff files were missing proof of flu shot, it is time for flu shots now and being scheduled. Site director MMR vaccination not in personnel file, a Technical Violation was issued.

All documents required to be posted were appropriately posted on the walls: License; Emergency Disaster Plan; Earthquake Preparedness checklist; Notification of Parents Rights; Personal rights; Child seatbelt laws; menus; daily activity schedules. One waiver for the facility was posted regarding outdoor shared space with the elementary school.

Site Director 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.

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

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: YMCA OF THE EAST BAY Y-KIDS PATTERSON
FACILITY NUMBER: 013422419
VISIT DATE: 09/07/2022
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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/inspection-process.

There were no deficiencies issued today.

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

Exit interview conducted and report was reviewed with the assistant Site Director Jennifer Kincheloe.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022
LIC809 (FAS) - (06/04)
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