010214206-4-5-2023-02-CC-DCAS-CQLVAW-20230405161639

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010214206
Report Date: 04/05/2023
Date Signed: 04/05/2023 04:16:55 PM

Document Has Been Signed on 04/05/2023 04:16 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:	STEPTOE-GRAY, DAVELLA		FACILITY NUMBER:	010214206
ADMINISTRATOR:	STEPTOE-GRAY, DAVELLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 436-6869
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	14	CENSUS:	DATE:	04/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Davella Steptoe-Gray		TIME COMPLETED:	04:30 PM

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On 04/05/2023 at 1:10pm Licensing Program Analyst (LPA) Diana Campos conducted an unannounced Annual Required inspection at Davella Steptoe-Gray Family Childcare Home. LPA met with licensee and explained the purpose of today's inspection. LPA was granted the inspection authority to enter the Home. The family childcare home days and hours of operation are Monday to Friday 06:00 AM to 06:00 PM. Present in the home at time of inspection were Licensee, licensee's spouse and 10 children in care consisting of 3 infants, 5 preschoolers and 2 school age children.

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

A health and safety tour of inside the home was done. LPA toured the premises with licensee. The home is a two story home with sufficient heating and ventilation for the safety and comfort of children in care. LPA inspected the on limit areas, which include the living room, kitchen, and the separate in-law unit that has been converted into a child care room behind the main house. The in-law unit includes a learning room, kitchen and a bathroom. The off limit areas include the entire upstairs level of the home, bedrooms on first floor next to the kitchen. The off limit areas are made inaccessible by gate, closed and/or locked doors and visual supervision. The isolation area is the living room. There is a gate for the bottom of the stairs, to prevent access by children. There is a 3A40BC fire extinguisher, smoke and carbon monoxide detector in the home.

Medicines, cleaning products, sharp objects are stored inaccessible to children today.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: STEPTOE-GRAY, DAVELLA	FACILITY NUMBER: 010214206
	VISIT DATE: 04/05/2023

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LPA reminded licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. Licensee states that there are no pets and arms and ammunition stored in the home. The fireplace is screened, and the home maintains a working telephone. LPA toured the outdoor area (backyard) and observed it was fenced. LPA observed there are no pools, hot tubs or other bodies of water.

Children files and Facility files were reviewed. Facility contained Children's Roster, Licensee’s mandated reporter training expires 6/13/2024, pediatric CPR and first aid expires 7/2024 .

This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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)/ (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 safe sleep regulations with licensee 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 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.

The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Davella Steptoe-Gray.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/05/2023 04:16 PM - It Cannot Be Edited

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: STEPTOE-GRAY, DAVELLA	FACILITY NUMBER: 010214206
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/05/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(g)(1)

Immunizations

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 5 out of 9 children's files did not include information regarding immunization records which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/26/2023
	Plan of Correction
1 2 3 4	Licensee shall submit proof of missing information regarding immunization records.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

LIC809 (FAS) - (06/04)

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