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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423778
Report Date: 08/14/2024
Date Signed: 08/14/2024 12:02:02 PM

Document Has Been Signed on 08/14/2024 12:02 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:SAINT PHILIP NERI PRESCHOOLFACILITY NUMBER:
013423778
ADMINISTRATOR/
DIRECTOR:		GRACE GORDILLO-BEATTYFACILITY TYPE:
860
ADDRESS:3108 VAN BUREN STTELEPHONE:
(510) 521-0787
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
08/14/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Grace Gordillo-BeattyTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA Alecia Sifuentes met with Director Grace Gordillo-Beatty for the purpose of a pre-licensing change of location inspection. Licensee requests a preschool component for 12 children age two years to entry into first grade. The program will operate Monday through Friday from 8:00 a.m. to 6:00 p.m. The fire clearance was granted and received on 8/12/2024. The facility will provide afternoon snacks and parents will provide breakfast and lunch.

LPA reviewed with Director the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

INDOOR ACTIVITY SPACE:
There is one preschool classroom located in the preschool building downstairs. LPA observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. There is a first aid kit located in the emergency backpack, playground, and cupboard. Medications will be stored in the top cupboard. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. LPA observed individual water bottles that are refilled through out the day. LPA observed a functional carbon monoxide detector in the classroom. LPA observed a sign in/out binder.

LPA measured the preschool classroom. The total classroom space contains a total of 1,246 square feet, which will accommodate Licensee's request for 12 preschool children. There is one toilet and one sink for the children located in the preschool classroom, and a separate private restroom for the staff located in the preschool classroom labeled Restroom.

Report continues on LIC809-C page 2.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SAINT PHILIP NERI PRESCHOOL
FACILITY NUMBER: 013423778
VISIT DATE: 08/14/2024
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Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area that is located across the street at 3100 Van Buren Street. The outdoor area is the current preschool outdoor activity space licensed under facility number 013423077. Licensee has requested a waiver to continue to utilize the preschool playground and has submitted a safety plan for review. The outdoor play area is fenced with a wooden fence that is at least four feet tall. LPA observed a sufficient amount of equipment and toys. LPA observed a play structure for the children. The play structure includes a safety label, which designates use for children 2 to 5 years old. There are no bodies of water on the premises. There are shaded areas supplied by trees and overhangs.

LPA used current measurements from report dates 6/17/2019, therefore LPA did not take measurements. The outdoor play area contains a total of 3,477 square feet, which will accommodate Licensee's request for 12 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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

LPA discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA discussed with Director any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Report continues on LIC809-C page 3.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SAINT PHILIP NERI PRESCHOOL
FACILITY NUMBER: 013423778
VISIT DATE: 08/14/2024
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Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Director was informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with Director Grace Gordillo-Beatty.

The following item is required before a license will be issued:
1. Pending Playground Waiver review.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC809 (FAS) - (06/04)
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