073409597-8-7-2024-02-CC-ASIS-D7WV7T-20240807161141

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409597
Report Date: 08/07/2024
Date Signed: 08/07/2024 04:11:51 PM

Document Has Been Signed on 08/07/2024 04:11 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:	YMCA OF THE EAST BAY FAIRGROUNDS		FACILITY NUMBER:	073409597
ADMINISTRATOR/ DIRECTOR:	CARRILLO, RAMONA		FACILITY TYPE:	860
ADDRESS:	1203 WEST 10TH STREET		TELEPHONE:	(925) 450-6952
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94509
CAPACITY: 16	TOTAL ENROLLED CHILDREN: 16	CENSUS: 47	DATE:	08/07/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:	Anita Retzinger		TIME VISIT/ INSPECTION COMPLETED:	12:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Director of Fiscal Services Anita Retzinger for the purpose of a pre-licensing inspection. Licensee is requesting to add a toddler component for 16 toddlers ages 18-36 months, a decrease in capacity for the infant component for 18 infants ages 0-24 months, and a decrease in capacity for the preschool component for 92 preschool children from age two years to entry into kindergarten for a total capacity of 126. The program currently operates Monday through Friday from 7:00 a.m. to 5:30 p.m. The fire clearance was granted and received on 7/29/2024. The facility currently provides breakfast, lunch, and afternoon snack. LPA informed Director that the facility will be converted to a single child care center license under one facility number 073409597, therefore LPA will be closing the current infant and preschool facility numbers 073408942/073408943. 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. LPA discussed the safe sleep regulations with the Regional Director 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. INDOOR ACTIVITY SPACE: There are two infant classrooms located in Rooms #1 and #2 in Building A, one toddler classroom located in Room #3 in Building B, and four preschool classrooms located in Rooms #4, #5, #6, and #7. Rooms #4 & #5 is located in Building B and Rooms #6 & #7 is located in Building C. LPA observed a sufficient amount of equipment, toys, tables, chairs, and cubbies for all classrooms. LPA observed a crib area dividing the indoor activity space using a four-foot-tall gate with nine cribs available in Room #1. Report continues LIC809-C page 2.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: YMCA OF THE EAST BAY FAIRGROUNDS	FACILITY NUMBER: 073409597
	VISIT DATE: 08/07/2024

NARRATIVE

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LPA observed napping cots for the toddlers and preschool children. There is a first aid kit in each of the classrooms. Medications will be stored in the office in a locked box. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. LPA observed water pitchers in each classroom. LPA observed a functional carbon monoxide detector in each building. LPA observed an electronic sign-in/sign-out system.

LPA measured the infant classrooms (Rooms #1 & #2). The infant classrooms contain a total of 1,441 square feet which will accommodate Licensee’s request for 18 infants. LPA measured the toddler classroom (Room #3). The toddler classroom space contains a total of 974 square feet which will accommodate Licensee’s request for 16 toddlers. LPA measured the preschool classrooms (Rooms #4, #5, #6, & #7). The preschool classroom spaces contain a total of 3,270 square feet which will accommodate Licensee’s request for 92 preschool children. There is one sink located in Rooms #1 and one sink located in Room #2. There are four more sinks and three toilets located in between Room #1 & #2. LPA observed a diaper changing table within arm’s reach of the sink. There are three sinks and two toilets in Room #3. There is one sink located in Room #4 and one sink located in Room #5. There are four more sinks and four toilets located between Rooms #4 & #5. There is one sink located in Room #6 and four sinks and three toilets located in Room #7. Staff restrooms are located near the entrance of each building. 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 are three outdoor areas on the property (Infant/Toddler Playground A, Preschool Playground B, and Preschool Playground C). The outdoor play area is fenced with a chain link fence that is at least four feet tall and separates the infant/toddler yard from the preschool yards. LPA observed a sufficient amount of equipment and toys. There are two play structures located on Preschool Playground B & C. LPA observed a safety label approved on both play structures approved for ages 2 to 12 years old. There are no bodies of water on the premises. There are shaded areas supplied by a tree and canopies.

Report continues on LIC809-C page 3.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: YMCA OF THE EAST BAY FAIRGROUNDS	FACILITY NUMBER: 073409597
	VISIT DATE: 08/07/2024

NARRATIVE

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LPA measured the Infant/Toddler Playground A. Director has divided the playground to designate an area for the toddlers and an area for the infants. The infant outdoor activity area is located near the front of the building and contains a total of 1,459 square feet which will accommodate Licensee’s request for 18 infants. The toddler outdoor activity area is located near the back and contains a total of 2,373 square feet which will accommodate Licensee’s request for 16 toddlers. LPA measured the Preschool Playgrounds B & C. The preschool outdoor activity spaces contain a total of 9,820 square feet which will accommodate Licensee’s request for 92 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.

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.

Report continues on LIC809-C page 4.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: YMCA OF THE EAST BAY FAIRGROUNDS	FACILITY NUMBER: 073409597
	VISIT DATE: 08/07/2024

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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 of Fiscal Services Anita Retzinger.

Effective today, 8/7/2024, LPA will approve the change of components serves and change of capacity for 18 infants ages 0-24 months in Rooms #1 & #2, 16 toddlers ages 18-36 months in Room #3, and 92 preschool children age two years to entry into kindergarten in Rooms #4, #5, #6, & #7.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

LIC809 (FAS) - (06/04)

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