010215251-1-22-2020-02-CC-PDYR-BL3QMZ-20200122111822

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010215251
Report Date: 01/22/2020
Date Signed: 01/22/2020 11:18:29 AM

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:	EDWARDS-ROBINSON, SHONTA		FACILITY NUMBER:	010215251
ADMINISTRATOR:	EDWARDS-ROBINSON, SHONTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 640-6349
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94603
CAPACITY:	14	CENSUS: 8	DATE:	01/22/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Ingrid Edwards		TIME COMPLETED:	11:20 AM

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 Annual/Random inspection was conducted by LPA Dyer. The licensee's fingerprint cleared assistants were present with 8 day care children (2 infants, 6 preschool-age). The licensee arrived at 10:00 a.m. Phone number is current. Hours: 7:30 a.m. - 5:30 p.m. The day care area of the home was inspected. Areas licensed for child care: The Learning Center (downstairs) and the downstairs bathroom. Off-limit areas will be made inaccessible to children by closed and/or locked doors; gates; and visual supervision. All required forms are posted and visible for public review. There was a working smoke detector (tested); a fully charged 2-A:10-B:C fire extinguisher; a first aid kit, and a carbon monoxide detector. 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. No fireplace in the day care area. There are no hazardous materials, medicines, or cleaning solutions accessible to children during this inspection. Hazardous items are kept in the off-limit area of the home, inaccessible to children. Licensee stated there were no firearms or bodies of water on the premises. Stairs inside the home are gated. Licensee has mats and a play yard for children to nap. Bedding is laundered weekly by the licensee. Back yard area continues to be off-limits to children. Children are taken to a local park for outdoor play. At 9:12 a.m., a sample of children's files were reviewed. All have emergency information in file. Licensee is conducting and documenting fire drills and utilizing the child care roster. 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. (continued)

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020

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: EDWARDS-ROBINSON, SHONTA	FACILITY NUMBER: 010215251
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/22/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/18/2020 Section Cited	1 2 3 4 5 6 7	Personnel Requirements. The Licensee and other personnel as specified shall complete training on preventive health practices including pediatric CPR and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement was not met as evidenced
	8 9 10 11 12 13 14	by document review and licensee interview: Licensee stated at 10:05 a.m. that she did not sign up for a CPR/First Aid Class when her previous class expired. Licensee also states there are no other records. This poses a potential health risk to the health and safety of children in care.	8 9 10 11 12 13 14	Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020

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: EDWARDS-ROBINSON, SHONTA	FACILITY NUMBER: 010215251
	VISIT DATE: 01/22/2020

NARRATIVE

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All staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee was reminded that anyone working, residing or frequently visiting the home must be fingerprint cleared prior to being in the presence of children, or an immediate civil penalty can be assessed. A qualified assistant must be physically present whenever 9 or more children are in care. When an assistant is not present, the home reverts back to small family child care ratios.

Licensee was aware of the New Regulations regarding Adult Immunizations and Mandated Reporter Training. Licensee has immunizations in file, and a current Mandated Reporter Training certificate that expires 2/24/21. Mandated Reporter training is available at www.mandatedreporterca.com (Child Care Provider Module).

Licensee stated at 10:05 a.m. that she did not sign up for a CPR/First Aid Class when her previous card expired.

Licensee was also reminded of the Department's Inspection authority, and the need to comply when notified that termination of an employee is necessary. The handout, "A Child Care Provider's Guide to Safe Sleep" was provided and discussed in detail at the last inspection and reviewed again today. Also discussed with the licensee: California School Immunization Record (blue) Cards, children in parked vehicles; substitutes; association; advertisements; changes in on-limit areas; construction work at facility; paying fees on-line and smoking. Licensee was encouraged to frequently visit the licensing website at www.ccld.ca.govfor licensing regulations, forms and updates.

SEE 809-D for deficiencies.

The attached type B deficiency is cited today and must be corrected by the due date. This poses a potential Health and Safety risk to clients in care. Failure to correct violations will result in a civil penalty, and repeat violations will result in additional penalties.

Notice of site visit must be posted for 30 days. Appeal rights were given and discussed. An exit interview was conducted. This report must be available for public review for 3 years.

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020

LIC809 (FAS) - (06/04)

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