010212906-6-29-2022-02-CC-PDYR-CFUV73-20220629161027

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010212906
Report Date: 06/29/2022
Date Signed: 06/29/2022 04:10:39 PM

Document Has Been Signed on 06/29/2022 04:10 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	BIGELOW, MARY & ERNEST		FACILITY NUMBER:	010212906
ADMINISTRATOR:	BIGELOW, MARY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 632-2518
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 7	DATE:	06/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Timeka Collier and Mary Bigelow		TIME COMPLETED:	04:00 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	An unannounced Required - 1 Year inspection was conducted by Licensing Program Analyst L. Dyer. LPA arrived at the facility at 11:00 a.m. The licensee's assistant was present with 7 day care children (2 infants, 5 preschool-age). The licensee arrived approximately 30 minutes later. Facility is in compliance with licensed capacity and facility ratios. Phone number and e-mail address are current. At 11:15 a.m. the day care area of the home was inspected. Areas licensed for child care: day care room, kitchen and bathroom. Off-limit areas will be made inaccessible to children by closed and/or locked doors; gates; and visual supervision. The home was clean and orderly, with adequate heating and ventilation. There were safe, healthful and comfortable accommodations, furnishings and equipment available to children at the time of this inspection. There were a variety of books and toys for children's use. There was a working smoke detector (tested); a fully charged 3-A:40-B:C fire extinguisher; a first aid kit, and a carbon monoxide detector. Fireplace was screened. There are no hazardous materials, medicines, or cleaning solutions accessible to children during this inspection. Children have riding toys, child sized house, bubbles, and other toys for outdoor play. LPA discussed the safe sleep regulations with the licensee and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and- resources/safe-sleep as an additional resource. LPA also informed licensee 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. (continued)

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BIGELOW, MARY & ERNEST	FACILITY NUMBER: 010212906
	VISIT DATE: 06/29/2022

NARRATIVE

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Licensee states infants have been supervised while sleeping, and is aware of the signs to be aware of: labored breathing, skin color, increase in body temperature and restlessness. Licensee states that infants sleep on their backs. There is no children with a Sleeping Plan with Section C in place. Children sleep in the day care room, and the licensee can visually observe when a child awakens from a nap.

Play yards were reviewed for each infant up to 12 months of age. Placement did not hinder the entrance or exit to and from the sleeping space. Mattresses were firm, sized appropriately, and were covered with a tightly fitted sheet. There are no objects hanging above or attached to the play yard, and no bumper pads. Older children sleep on mats. Licensee states sheets are replaced when soiled or wet, and individual bedding is only used by one child only. Soiled bedding is placed in a closed container and is inaccessible until washed. Bedding is washed daily.

LPA reviewed facility, children's and personnel records at 12:45 p.m. Licensee's Mandated Reporter Training and CPR/First Aid are current. Last disaster drill completed on 6/29/22. All files are complete and all required postings are visible for public review. Facility roster was current.

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500 maximum per day/per person will be assessed if this regulation is violated. Licensee was also reminded of the Department's Inspection authority, and the need to comply when notified that termination of an employee is necessary.

Also discussed with the licensee: supervision of children at all times; children are not to be left in parked vehicles; car seats and high chairs; Unusual Incident Reporting; changes in on-limit areas, paying fees on-line; smoking; ill children in home, and the Guardian background check process.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at: www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
(continued)

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BIGELOW, MARY & ERNEST	FACILITY NUMBER: 010212906
	VISIT DATE: 06/29/2022

NARRATIVE

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Important E-mail Addresses:
Community Care Licensing General Information and Updates:www.ccld.ca.gov. For updates, click the "Receive Important Updates" box.
Mandated Reporter Training: www.mandatedreporterca.com (Child Care Providers Module - required every 2 years).
Alameda County Public Health Department Website: www.acphd.org
Guardian: background check process with self-service options: https://www.cdss.ca.gov/inforesources/ cdss-programs/community-care-licensing/caregiver-background-check/guardian.

NO DEFICIENCIES CITED TODAY.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Mary Bigelow.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

LIC809 (FAS) - (06/04)

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