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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010215056
Report Date: 12/06/2021
Date Signed: 12/06/2021 04:22:06 PM

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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:BERKLEY, MARIAFACILITY NUMBER:
010215056
ADMINISTRATOR:BERKLEY, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 484-5329
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY:12CENSUS: 4DATE:
12/06/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:TIME COMPLETED:
04:30 PM
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December 6, 2021 Licensing Program Analyst (LPA) Lorraine Dacanay Breaux conducted an unannounced 1 year required inspection. Present during today’s inspection was the licensee, Maria Berkley and her fingerprint cleared daughter and 4 (four) children in care. Hours of Operation Monday - Friday 7:45 AM - 5:00 PM. The home was toured for Health and Safety Inspection.

On limits area consist of the living room, dining room, family room, downstairs bathroom and backyard. (Master bedroom bathroom is on limits for temporary and/or emergency use). The remainder of the home is off limits. The home was observed to be orderly, with heating and ventilation. This home has a swimming pool that is properly gated for the children's safety. There are no firearms on the premises as stated by the licensee. Detergents, cleaning compounds, medications and other items which could pose a danger to children are stored and inaccessible to children. Stairs are gated. The fireplace is screened to prevent access by children. LPA verified that the fire extinguisher is fully charged. The home is equipped with both a smoke detector and carbon monoxide detector. There is a working telephone in the home. The home provides appropriate toys.
All off limit areas are inaccessible by closed and/or locked doors and visual supervision. Per the licensee, the ISOLATION AREA will be in family room.

The outdoor play area has a fence and are free from defects and dangerous conditions. LPA did not observe any hazardous materials, or toxins accessible to children on the premises during the inspection.

Children's files were reviewed and found to be complete. The facility roster was reviewed, and a copy obtained. All files were complete and the licensee is in ratio today.

See 809-C.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2021
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: BERKLEY, MARIA
FACILITY NUMBER: 010215056
VISIT DATE: 12/06/2021
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The licensee’s Pediatric CPR/First Aid certificate has expired (pending appointment from Hively). Licensee and all adults living in the home are in compliance with immunization law which pertains to day care providers, and mandated reporter training.

LPA reminded the licensee of the following: Mandated Reporter training is to be renewed every two years, CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. The Licensee’s Health and Safety training is completed.



Incidental Medical Services (IMS) policy was discussed. 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.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $500 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

LPA Breaux provided a copy of Safe Sleep-in child care brochure, a handout "What Does A Safe Sleep Environment Look Like," and a copy of the new California Car Seat Law Changes. The licensee was provided information regarding effects of Lead Exposure and testing requirements (Assembly Bill 2370).

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee [or facility representative] Maria Berkley.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2021
LIC809 (FAS) - (06/04)
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