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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700663
Report Date: 09/13/2024
Date Signed: 09/13/2024 01:56:26 PM

Document Has Been Signed on 09/13/2024 01:56 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:CAPE CROCE CENTERFACILITY NUMBER:
015700663
ADMINISTRATOR/
DIRECTOR:		REGINA GARCIAFACILITY TYPE:
860
ADDRESS:5650 SCENIC AVETELEPHONE:
(925) 606-4706
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 0DATE:
09/13/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Regina Garcia and Aida WhiteTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Brindha Govindasamy and Licensing Program Manager (LPM) Mai Lor met with Applicants Regina Garcia for the purpose of change location inspection from facility #015700656. Also present during this inspection is Support Services Manager Aida White. Applicant requests a preschool license to serve 20 preschool children from age three to entry into kindergarten. The center is located on the Leo Croce Elementary school site. The program will operate Monday through Friday from 8:00 a.m. to 5:00 p.m. The fire clearance was granted and received on 08/29/2024. The facility will provide breakfast, lunch, and afternoon snacks.

LPA reviewed with applicant 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 (classroom #5). LPA observed sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. There is a first aid kit in the classroom. Medications will be stored in the office in a locked box. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. LPA observed water pitcher in the classroom. LPA observed a functional carbon monoxide detector in the sink area. Applicant stated electronic sign-in/sign-out system will be utilized for sign-in/sign-out.

(Report continues on subsequent LIC 809)
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2024
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 4
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: CAPE CROCE CENTER
FACILITY NUMBER: 015700663
VISIT DATE: 09/13/2024
NARRATIVE
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LPA measured one classroom. The total classroom space contains a total of 741.63 square feet, which will accommodate Applicant's request for 20 preschool children. There is one toilet and two sinks for the children, and a separate private restroom for the staff located outside of the classroom. The applicant is requesting to use the elementary school’s girls’ restroom which has six toilets and three sinks to accommodate the requesting capacity. The applicant has submitted a waiver request to share the elementary school’s restroom. Applicant stated children who become ill during the day will be isolated in the office area and will use the classroom restroom, if necessary. In the event that the classroom restroom is being used for sick children, the Applicant stated the rest of the children will utilize the elementary school’s restroom for the duration.

OUTDOOR ACTIVITY SPACE:
The facility does not have their own outdoor space. Applicant is requesting to share the outdoor space with the special education preschool program. The outdoor play area is fenced with a chain link fence that is at least four feet tall and separates the preschool yard from the elementary school. LPA observed sufficient amount of equipment and toys. The play structure includes a safety label without the age rating. Applicant was to advise to follow manufacturer guideline. There are no bodies of water on the premises. Shade is supplied by awning and trees.

LPA measured the outdoor activity space. The outdoor play area contains a total of 6,686.68 square feet, which will accommodate Applicant's request for 20 preschool children. LPA observed one sand box and three locked storages shed which store outdoor equipment for the preschool children.

(Report continues on subsequent LIC 809)
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CAPE CROCE CENTER
FACILITY NUMBER: 015700663
VISIT DATE: 09/13/2024
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APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated 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’s ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA discussed with Applicant 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.

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, 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.

Applicant 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.

(Report continues on subsequent LIC 809)

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CAPE CROCE CENTER
FACILITY NUMBER: 015700663
VISIT DATE: 09/13/2024
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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.

Assembly Bill (AB) 2370, Chapter 676, Statues 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-year after the date of the first test.

For child care 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).

Exit interview conducted and report was reviewed with the Applicant Regina Garcia and Support Services Manager Aida White.

The following items are required before a license will be issued:

  1. Submit Indoor and Outdoor Sketch to include overall facility, dimensions, location of staff and children's restroom, isolation area
  2. Submit shared restroom waiver to include supporting documents.
  3. Submit playground waiver to share with the special education preschool program.
  4. Submit Control of Property
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024
LIC809 (FAS) - (06/04)
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