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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422435
Report Date: 10/16/2024
Date Signed: 10/16/2024 12:38:28 PM

Document Has Been Signed on 10/16/2024 12:38 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ST. RAYMOND PRESCHOOLFACILITY NUMBER:
013422435
ADMINISTRATOR/
DIRECTOR:		WRIGHT, MAUREENFACILITY TYPE:
850
ADDRESS:11557 SHANNON AVE.TELEPHONE:
(925) 574-7423
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 21DATE:
10/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Person incharge, Jasmine Zepeda TIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) Jyoti Saini met with the person in charge, Jasmine Zepeda, for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Staff. Director Maureen Wright arrived during the inspection. In addition to the Director, 21 children, and two staff members are present today. The facility operates Monday - Friday from 7:00 AM to 6:00 PM in the early education building. The facility was inspected indoors and outdoors today for health and safety hazards, and the following was observed. There is a working fire alarm system in the facility. The facility has a working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available. Per Director, There are no firearms on the premises. During today's inspection, LPA did not observe any bodies of water. The center is in good condition, has proper temperature and ventilation, and is free of any hazards. All furniture is in good repair. The outdoor play area is fenced for supervision. The play structure is age-appropriate and in good condition. The playground has four outdoor tables with canopies for shade. There are separate bathrooms for the children and Staff. There is drinking water readily available for children using water bottles brought from home, and the facility refills the water bottles using a water fountain. The children bring snacks and lunch; however, the facility has extra nonperishable snacks for emergencies. The classroom has appropriate postings. The last Emergency Drill was conducted on 09/24/2024 and is properly logged. The facility utilizes a fact management system to sign in and out the children. LPA reviewed Staff and children's files. The staff records reviewed were complete. All Staff have a criminal record clearance on file. All the staff members and the site Director has a current Pediatric First Aid/CPR certificate on file. A copy of the facility personnel report and children's roster were available for review, and a copy was obtained.
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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ST. RAYMOND PRESCHOOL
FACILITY NUMBER: 013422435
VISIT DATE: 10/16/2024
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Criminal Record Clearance -

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Lead Testing –


CCC COMPLETED TESTING
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.
Incidental Medical Services (IMS)
This facility provides Incidental Medical Services – IMS. Currently there are no children on medications.
For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

MyChildCarePlan.org
Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ST. RAYMOND PRESCHOOL
FACILITY NUMBER: 013422435
VISIT DATE: 10/16/2024
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

No deficiency cited today.



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, Mureen Wright.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024
LIC809 (FAS) - (06/04)
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