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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700597
Report Date: 03/07/2023
Date Signed: 03/07/2023 04:19:04 PM

Document Has Been Signed on 03/07/2023 04:19 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:LITTLE APPLE ACADEMYFACILITY NUMBER:
015700597
ADMINISTRATOR:LEI, TONGXINFACILITY TYPE:
850
ADDRESS:2000 EAST 14TH STREETTELEPHONE:
(415) 623-0837
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 0DATE:
03/07/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Tongxin LeiTIME COMPLETED:
04:30 PM
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A Prelicensing inspection was conducted today 03/07/2023 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met with Applicant, Tongxin Lei. The applicant has submitted a NEW application for a PRESCHOOL license for 50 preschoolers. The program will operate from 8AM - 6PM, Monday through Friday, in 5 classrooms (Classrooms 1 through 5) and an art activity area. Also on site is an Infant component (max cap: 26) operating out of classroom 6 & 7. A health and safety inspection was conducted inside and outside and the measurements are as follows:

INDOORS: 1795.78 square feet = 51 children
OUTDOORS: 6554.36 square feet = 87 children

The center has obtained an approved fire inspection clearance from the Alameda County Fire Department on 2/17/2023. The fire clearance states the following: Large room at the rear of building not to be used for daycare - storage use only.

The facility has 5 classrooms and an open art area for preschool children use. The preschool rooms are equipped with varied age appropriate materials and equipment. There are 4 toilets, 1 urinal and 5 sinks available for children use. Staff toilet is located within the back hallway. Facility will utilize a catering company for lunch, facility will provide AM/PM snacks as well. Menu will be posted at least one week in advance in a place visible for the authorized representative to see. Facility will utilize the Director's office and staff bathroom as necessary for an ill child. Cots and mats were observed today.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2023
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: LITTLE APPLE ACADEMY
FACILITY NUMBER: 015700597
VISIT DATE: 03/07/2023
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This facility plans to provide Incidental Medical Services - IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

There are 2 play yards which are fenced in all around. Facility will utilize a cushioned fenced play area as well as the facility parking lot for outside play. The facility parking lot will be used for drop off/pick up only and then gates will be closed to incoming traffic and become a bike/ball area for the children. No cars will be within the parking lot while being utilized as a play yard. Staff must ensure that gates are closed prior to allowing children out in the yard. The center has water dispensers to provide clean drinking water inside and outside, with children bringing their water bottles from home. No cleaning agents were found stored with food. There is a refrigerator available. First aid supplies are available in the center. There is a working telephone on site. Facility will utilize an electronic sign in/out software that has a separate PIN/login for each authorized representative. Paper sign in/out sheets will be utilized should the electronic software be unavailable.

Applicant 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant 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 applicant 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.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: LITTLE APPLE ACADEMY
FACILITY NUMBER: 015700597
VISIT DATE: 03/07/2023
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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.

A license for 50 preschool children will be issued once the following items are received:


- A qualified Director packet is received an approved.
- Photographic proof of shade on the play yard.

Exit interview conducted with Applicant, Tongxin Lei.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023
LIC809 (FAS) - (06/04)
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