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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400297
Report Date: 09/26/2024
Date Signed: 09/26/2024 10:37:08 AM

Document Has Been Signed on 09/26/2024 10:37 AM - 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:CHILDREN'S PRE-SCHOOL CENTER, THEFACILITY NUMBER:
434400297
ADMINISTRATOR/
DIRECTOR:		YENIKOMSHIAN, OLLIAFACILITY TYPE:
830
ADDRESS:4000 MIDDLEFIELD ROAD T-1TELEPHONE:
(650) 493-5770
CITY:PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: DATE:
09/26/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Ollia YenikomshianTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
NARRATIVE
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On 09/26/2024 at 9:10am, Licensing Program Analyst (LPA) Jialing “Julianne” Zhu conducted an unannounced case management inspection for the purpose of investigating a reported incident. LPA met with Director Ollia Yenikomshian. Also present during the inspection were 10 fingerprint-cleared staff and 28 children (6 infants and 22 toddlers) in care. The facility is within ratio and in compliance with capacity regulations today. The facility was toured to conduct a Health and Safety Inspection.

The incident occurred on 09/16/2024 and was reported to Licensing on 09/17/2024. Per director, one (1) toddler was alone in the Dragonflies classroom for approximately 6 minutes unsupervised until a parent found the toddler.

Prior to today’s inspection, Director submitted the following information to Licensing: updated Unusual Incident/Injury Report with detailed list of actions taken or will be taken by facility, witness accounts of the incident, sign-in/out sheet for the day of the incident, resignation letter of the teacher, and email notification to parents regarding the incident.

During today’s inspection, LPA reviewed the above information with Director and conducted interview to obtain more information. LPA obtained minutes and attendance sheet from the all staff meeting conducted on 09/23/2024. LPA also observed the Dragonflies classroom where the child was found and the outdoor space where the teachers and other children were. The outdoor play area is directly outside the classroom. Per director, the door to the classroom leading to the outdoor play area was closed, thus the teachers’ view of inside the classroom while outside was fully obstructed. Based on the obtained information and LPA’s observations, LPA determined the child was left unsupervised, which posed an immediate threat to the health and safety of the child in care. LPA observed the following precautions taken by the facility following the incident: door lever locks are now installed for all door levers of Infant-Toddler classrooms. (Lever locks for handles on the inside of the classrooms were installed prior to this incident.) Alarms have also been installed on the doors for Toddler classrooms, which sounds every time the door opens. Page 1 of 2. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2024
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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CHILDREN'S PRE-SCHOOL CENTER, THE
FACILITY NUMBER: 434400297
VISIT DATE: 09/26/2024
NARRATIVE
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Absence of supervision is an Immediate $500 violation. As a result, a Type A deficiency is issued and a civil penalty of $500 is assessed during today’s inspection. (See LIC 809D.)

As a result of the Type A deficiency cited during today’s inspection, a copy of this report and LIC 9224 Acknowledgment of Receipt of Licensing Reports must be provided to parents/guardians of current enrolled children in care and all children enrolled following a 12-month period of this report. The LIC 9224 must be signed within the next business day the children are in care and is to be kept in the children’s files.

A Notice of Site Visit was given and must remain posted for 30 days. Exit interview was conducted, report was reviewed, and Appeal Rights were provided to Director Ollia Yenikomshian.

Page 2 of 2. End of Report.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/26/2024 10:37 AM - It Cannot Be Edited


Created By: Jialing Zhu On 09/26/2024 at 10:12 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CHILDREN'S PRE-SCHOOL CENTER, THE
FACILITY NUMBER: 434400297

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2024
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision 101229(a)(1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation.
This requirement was not met as evidenced by:
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LPA obtained sufficient information from Director to conclude this deficiency has been addressed with all parties involved with the facility. Precautions following this incident have also already been taken. (See LIC 809 for the information LPA obtained and observations of precautions taken as a result.)
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Based on observation and interview, the licensee did not comply with the section cited above as a child was left unsupervised in the classroom, which posed an immediate threat to the health and safety of the child in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Chandra Charles
LICENSING EVALUATOR NAME:Jialing Zhu
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2024


LIC809 (FAS) - (06/04)
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