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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422456
Report Date: 08/27/2024
Date Signed: 08/27/2024 02:32:47 PM

Document Has Been Signed on 08/27/2024 02:32 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:OLIVE CHILDREN AT ST. JAMES CATHOLIC CHURCHFACILITY NUMBER:
013422456
ADMINISTRATOR/
DIRECTOR:		HARRIS, CARMINAFACILITY TYPE:
850
ADDRESS:34700 FREMONT BLVD.TELEPHONE:
(510) 770-4999
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 90TOTAL ENROLLED CHILDREN: 36CENSUS: 33DATE:
08/27/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Carmina HarrisTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 8/27/2024 at 9:50AM Licensing Program Analyst (LPA) Jaleesa Jackson met with Director Carmina Harris for an Unannounced Annual/Random Inspection. The facility is located on the St. James Catholic Church grounds. Present during the inspection were 16 preschool age children, 7 toddlers and 6 fingerprinting cleared staff members. LPA toured the classrooms for a health and safety inspection. The facility is one large room with floor to ceiling dividers creating the different rooms. The divider separates the toddlers in their own section away from the preschool aged children. The facility operates 8:00AM – 6:00PM, Monday – Friday.

The facility has age-appropriate materials in the classrooms that were observed to be clean and in good condition. During today's inspection all toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. The children’s bathrooms are in good condition. All children have access to clean drinking water in each classroom. The facility has working carbon monoxide detectors, fully charged fire extinguishers and smoke detectors on site. There is a separate staff bathroom on site as well.

The kitchen is in the back of the facility and inaccessible to the children in care. It is clean, well maintained, and free from defects. Facility provides all food for the children. All food that will be brought from the children’s home will be properly labeled and stored. Facility receives meals from the Child and Adult Care Food Program (CACFP).

The 2 outside play yards are clean with age-appropriate materials for the children. The preschool play yard has artificial grass for cushioning and the toddler play yard has tan bark. Both yards are fully fenced and have plenty of shade for the children. LPA observed a water fixture for water play that was emptied and locked when not in use in the preschool play yard. There is also a sandbox that is fully covered when not in use.

Continued 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: OLIVE CHILDREN AT ST. JAMES CATHOLIC CHURCH
FACILITY NUMBER: 013422456
VISIT DATE: 08/27/2024
NARRATIVE
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 LPA reviewed 5 children's and found all to be complete. Facility is documenting sleep logs for the infants enrolled in the toddler program. LPA reviewed all staff files and found that one staff is missing the TDAP and MMR, 1 staff is has an expired Mandated Reporter, 1 staff member did not have a current Tuberculosis test, and 1 staff does not have a current health history in their file. All required postings are made visible on the window by the back entrance. The fire/disaster drill log is complete with the last drill logged on 6/28/2024.

There were 4 deficiencies cited on today's visit. See 809-D for deficiency.

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.

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.

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.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).



Continued 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
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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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: OLIVE CHILDREN AT ST. JAMES CATHOLIC CHURCH
FACILITY NUMBER: 013422456
VISIT DATE: 08/27/2024
NARRATIVE
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LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 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/.

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

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 Carmina Harris.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
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Document Has Been Signed on 08/27/2024 02:32 PM - It Cannot Be Edited


Created By: Jaleesa Jackson On 08/27/2024 at 01:44 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: OLIVE CHILDREN AT ST. JAMES CATHOLIC CHURCH
FACILITY NUMBER: 013422456

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in the center did not complete the lead testing prior to the deadline in the written directive which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/27/2024
Plan of Correction
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Lead testing is complete as of 6/6/2024. Deficiency has been cleared as of today.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1 staff has an expired mandated reporter which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director will submit the completed mandated report certificate to LPA by email by POC date.
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: 08/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2024


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Document Has Been Signed on 08/27/2024 02:32 PM - It Cannot Be Edited


Created By: Jaleesa Jackson On 08/27/2024 at 01:44 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: OLIVE CHILDREN AT ST. JAMES CATHOLIC CHURCH
FACILITY NUMBER: 013422456

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above in 1 out of 7 staff did not have MMR and TDap on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director will submit proof of MMR and TDap for the staff member that is missing the immunizations in their record to LPA by email by POC date.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based onrecord review, the licensee did not comply with the section cited above in 1 staff did not have a complete health history on file and 1 staff does not have a TB test that was complete no more than 12 months from the date of hire which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director will submit the completed health history for the one staff that is missing their health history and the other staff member that is missing their current TB to LPA by email by POC date.
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: 08/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2024


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