010215117-1-30-2020-02-CC-MMAR-BLC23Z-20200130160310

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010215117
Report Date: 01/30/2020
Date Signed: 01/30/2020 04:03:18 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	JOSEPH-WHITEHEAD, DELORIS J		FACILITY NUMBER:	010215117
ADMINISTRATOR:	WHITEHEAD-HARDIN, DELORIS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 482-9635
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94602
CAPACITY:	12	CENSUS: 8	DATE:	01/30/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Deloris Joseph-Whitehead		TIME COMPLETED:	04:15 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	On 01/30/2020 at 2:45 PM Licensing Program Analysts (LPAs) Monica Mathur and Arminder Singh conducted an unannounced Annual/Random Inspection at Deloris Joseph-Whitehead's Family Day Care Home. LPA met with Licensee, Deloris and explained the purpose of today’s inspection. Present in the home were Licensee, her adult daughter and adult grand daughter and seven (7) day care children (5 preschool and 2 school age). At 3:40 PM another school age child arrived, making total of 8 children (3 school age and 5 preschool age) present. Facility is in compliance with required ratios today. Children were engaged in various activities under the supervision of the Licensee. Days and hours of operation are Monday - Friday from 5:30 AM - 6:30 PM. Adults over the age of 18 and residing in the home are the Licensee, Licensee's spouse, and daughter. All adults have Criminal Background Check Clearances, TB clearance and signed Criminal Record Statements LIC508 on file with Licensing Office. At 3:00 PM LPA toured the indoor and outdoor areas of the home during today's inspection: INDOOR SPACE: In Use Areas: Kitchen, Living room, Dining area, Bathroom down the hallway. Off Limit Areas: All 3 bedrooms and 1 bathroom inside. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Furniture and equipment, such as chairs, and tables were age appropriate and in good condition. There were no baby walkers or bouncers observed on the premise during today’s inspection. The home is safe for the day care children. LPA did not observe any wall heaters in the home. There is no fireplace inside the home. There are no stairs inside the home. CONTINUED ON NEXT PAGE

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020

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: JOSEPH-WHITEHEAD, DELORIS J	FACILITY NUMBER: 010215117
	VISIT DATE: 01/30/2020

NARRATIVE

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OUTDOOR SPACE: In Use Areas: Covered Patio and Grass area.
The outdoor space and play equipment were observed to be maintained in safe condition and free of hazards. The yard was fenced and there were no bodies of water.

LPA observed a fully charged 2A10BC fire extinguisher in Kitchen and working smoke / carbon monoxide detectors. The Licensee states that she does not have any weapons. There is 1 small pet dog in the home that stays in the backyard during the operation hours. LPA reviewed a current Children Roster and obtained a copy. Last fire/disaster drill was completed on 12/23/19. All required postings including but not limited to Parent Rights Poster, Facility License, Emergency Disaster Plan were observed posted on a wall in the entrance area. The Licensee states that she does not transport children. Licensee states that she supplies snacks and meals to the children. LPA discussed Healthy Beverages Act with the Licensee. Day care home appeared to be free of flies, other insects, and rodents during today’s inspection.

FILE REVIEW:
At 3:15 PM Five (5) Children's files were reviewed and contained all required Licensing forms and records including but not limited to Receipt for Parents' Rights, Immunization record, Identification & Emergency Information, Consent for Medical Treatment, Affidavit Regarding Liability Insurance, Health History.
Licensee file contained Criminal Record and Child Abuse Index Clearance, TB clearance, Statement Acknowledging Requirement to Report Suspected Child Abuse, Immunizations for Measles, Pertussis, Flu and required Mandated Reporter Training per AB1207. Licensee's certifications for CPR and First Aid are current and expire on 03/14/2020.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during 80% of the operating hours of the day care and ensure that the children are supervised at all times. The Licensee understands her capacity options and that she cannot have more than 14 children in the home at any time with at least two qualified adults present. Licensee also understands that she must comply with the ratio and capacity requirements of the Small Family Child Care Home license whenever she or a qualified adult is alone with the children.
CONTINUED ON NEXT PAGE

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020

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: JOSEPH-WHITEHEAD, DELORIS J	FACILITY NUMBER: 010215117
	VISIT DATE: 01/30/2020

NARRATIVE

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LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who comes in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12-month period.

LPA advised the Licensee of the required Mandated Reporter Training for Child Care Providers that all Licensees and employees are required to complete as of January 1, 2018. The website for the online training is: http://www.mandatedreporterca.com/training/childcare.htm.

Incidental Medical Services (IMS) policy was discussed. The Licensee stated that she currently does not have any children in care who requires IMS. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Beginning January 1, 2019 AB 2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility. LPA also provided the “Safe Sleep Information Flyer” to Licensee.

Website links for free subscription to Quarterly Updates Newsletter:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates
or
Send email to: childcareadvocatesprogram@dss.ca.gov

In the areas that were evaluated, no regulatory violations were observed. Exit Interview was conducted, where this report was reviewed and discussed with Licensee. Licensee signed the report acknowledging receipt of documents.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED NEAR THE FRONT ENTRANCE TO THE HOME FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020

LIC809 (FAS) - (06/04)

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