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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423745
Report Date: 08/10/2023
Date Signed: 08/10/2023 01:49:40 PM

Document Has Been Signed on 08/10/2023 01:49 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:SHU REN INTERNATIONAL SCHOOLFACILITY NUMBER:
013423745
ADMINISTRATOR:YI QUEFACILITY TYPE:
850
ADDRESS:1422 SAN PABLO AVENUETELEPHONE:
(408) 508-6259
CITY:BERKELEYSTATE: CAZIP CODE:
94702
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 0DATE:
08/10/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Charles Miller and Queena ZhengTIME COMPLETED:
02:00 PM
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On 08/10/23 Licensing Program Analyst (LPA) Melissa Domantay arrived at the facility for an announced pre licensing inspection. LPA met with the Applicant, Charles Miller and Site Director Queena Zheng. An application for a preschool license was received for this facility. The facility will operate Monday-Friday 7:30AM to 6:00PM. The preschool has 4 classrooms for children to utilize. LPA toured all areas that will be used by and for children, to conduct a health and safety inspection, and the measurements are as follows:

INDOORS: 2,609.34 square feet= 74 children
OUTDOORS: 5656.05 square feet= 75 children

A fire clearance, with a total capacity of 75 preschoolers, ages 2 years to first grade entry, was received from the Berkeley Fire Department on 07/31/23.

LPA observed that all areas have sufficient lighting, heating and ventilation for the safety and comfort of children and staff. The floors and surfaces are clean and in good condition. There is an ample supply of age appropriate activities, equipment, and furniture that is in good condition. There is a total of 7 toilets and 8 sinks available for children, and they are in sanitary and operational condition. There is a separate bathroom for staff. The office and the front desk area will be used for the isolation of sick children. The facility will provide snacks and lunch will be provided by families from home. LPA observed an ample supply of napping mats, which will be stored in the storage closet. The facility will utilize an electronic sign in/out system.

The facility is equipped with multiple 3A40BC fire extinguishers, pull down fire alarms, a centralized smoke and carbon monoxide detection system, working telephone, and first aid supplies. LPA did not observe any hazardous items, toxins, bodies of water or medication accessible to children during today's inspection. See 809-C for continuance
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2023
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: SHU REN INTERNATIONAL SCHOOL
FACILITY NUMBER: 013423745
VISIT DATE: 08/10/2023
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LPA observed the outdoor playground, which is fully fenced. There is a sandbox for children to utilize and was observed to be maintained. Applicant provided play structure product description, which states the play structure is designated for age group 2-12 years. The playground is pending approval/to be licensed once the construction and cushioning around the play structure and play areas are complete. Applicant will provide photos of outdoor playground shading once it has been set up.

Queena will be considered a qualified Director once Administration/Staff Relations course is completed. Site Director has provided proof of enrollment in an Administration/Staff Relations course to LPA. Applicant and Director will submit a request for an exception for Site Director Queena to be Director at facility while completing required Administration/Staff Relations course.

If this facility plans to provide Incidental Medical Services – IMS. A Plan of Operation that includes IMS must be submitted to the Department. 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.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. LPA reviewed responses and provided technical assistance including postings. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and the director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

A preschool license for a capacity of 74 children is pending until outdoor playground is complete and cushion around the play structure is fully set up and an exception request for Site Director, Queena Zheng to be Director is submitted for approval by LPM Mendoza. There are no deficiencies being cited today. Exit interview conducted with Applicant, Charles Miller and Site Director, Queena Zheng.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023
LIC809 (FAS) - (06/04)
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