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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423125
Report Date: 04/24/2024
Date Signed: 04/24/2024 01:40:14 PM

Document Has Been Signed on 04/24/2024 01:40 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:DOLMA CHILD CARE CENTERFACILITY NUMBER:
013423125
ADMINISTRATOR/
DIRECTOR:
ZORIGHT, GERELBATFACILITY TYPE:
850
ADDRESS:1700 - 7TH STREETTELEPHONE:
(510) 414-8447
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
04/24/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Gerelbat ZorightTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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On April 23, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director/Teacher Gerelbat Zoright to conduct an unannounced annual continuation inspection. There were 8 preschool age children and two fingerprint cleared staff. There is also an Infant component on site, #013423125. The teacher/child ratio was being met today. The center was toured for a health and safety inspection. The facility operates from 8am – 10pm Monday through Sunday.

Classrooms: The preschool operates out of one classroom. All sinks and toilets are observed to be clean and in proper working order. The facility has age appropriate materials in all classrooms that are observed to be clean and in good condition. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. The children bring water bottles from home and refill them throughout the day from the pitchers filled with tap water. There is a working combined Carbon Monoxide and smoke detector, a fully charged fire extinguisher and a working telephone. The fire system is hard wired.

Outdoor: The outdoor play area is clean with ample age appropriate materials for the children. The yard is fully fenced in and has plenty of shade for the children. LPA did not observe any harmful or unattended bodies of water in or around the facility.
Isolation area: Is in the office

Food Service: Two snacks are provided to the children and lunch is brought from home. LPA observed the snack menus posted. The food preparation area is a kitchenette with no stove; and was observed be clean, well maintained, free from defects, and hazards. All drawers and the refrigerator were all secured with child safety locks.

Records: The fire/disaster drill log was complete with the last drill logged March 7, 2024. A physical census of the children was taken and cross referenced with the electronic sign-in and out log. All staff have obtained
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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2024
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: DOLMA CHILD CARE CENTER
FACILITY NUMBER: 013423125
VISIT DATE: 04/24/2024
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a criminal record clearance. LPA reviewed six children files, all children files were complete. LPA reviewed two staff files and found the files to be complete. The parent board was inspected and had required postings attached to the board.

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone or fax. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

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.

Director 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). LPA verified that the lead testing

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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: DOLMA CHILD CARE CENTER
FACILITY NUMBER: 013423125
VISIT DATE: 04/24/2024
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was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. CCC COMPLETED LEAD TESTING AND NO LEAD EXCEEDANCE DETECTED. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

This facility does not provide Incidental Medical Services – IMS. 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/.

Director 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.

There were no deficiencies cited during today's visit.

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

Exit interview conducted.

Report was reviewed with Director Tenzin Paldon who gave her husband Gerelbat Zoright permission to sign the report.

************************************** End of Report ***********************************

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
LIC809 (FAS) - (06/04)
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