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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013414465
Report Date: 07/22/2024
Date Signed: 07/22/2024 02:49:36 PM


Document Has Been Signed on 07/22/2024 02:49 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:RIDDLE, MARYFACILITY NUMBER:
013414465
ADMINISTRATOR:RIDDLE, MARYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 797-9967
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY:14CENSUS: 10DATE:
07/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Mary RiddleTIME COMPLETED:
03:00 PM
NARRATIVE
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On 7/22/2024 at 12:30PM Licensing Program Analyst (LPA) Jaleesa Jackson met with Licensee Mary Riddle for an Annual/Random visit. Present during the inspection was the Licensee, her adult daughter/assistant, 3 infants, 3 preschool age children and 4 school age children. The facility operates 8:00AM – 5:30PM, Monday - Friday.

ON LIMITS AREA: Living Room, Family Room (Childcare Area), Kitchen, Hallway Bathroom and Backyard

OFF LIMITS AREA: Three Bedrooms, Master Bathroom, Garage, Left and Right Side of Backyard

ISOLATION AREA: Living Room

The facility is a single-story home rented by the Licensee. The inside of the home is observed have age-appropriate materials for the children. All off-limit areas were made inaccessible with gates, locks, and closed doors. Licensee has stated that there are no firearms in the home. Licensee stated that there is 1 small dog and 2 cats in the home.

The home has a fully charged 2A10BC fire extinguisher next to the kitchen sink. There is a combination smoke/carbon monoxide detector in the family room. The home is equipped with central heat and plenty of windows and portable air conditioner for proper ventilation. Licensee provides all food for the children. All food that is brought from the children’s home will be properly labeled and stored. The fireplace in the family room is blocked with a bookshelf making it inaccessible to the children in care. Licensee stated she does not transport children. The back yard is fully fenced and well maintained. LPA did not observe any harmful bodies of water in or around the home.
Continued 809-C
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa JacksonTELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2024
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: RIDDLE, MARY
FACILITY NUMBER: 013414465
VISIT DATE: 07/22/2024
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LPA reviewed children's files and 2 child's files were missing immunization's. Licensee’s Health and Safety training has been completed and Pediatric CPR and First Aid training expires 8/26/2025. All required forms are posted and visible for public view in the family room. The fire drill log is complete with the last drill logged 3/15/2024. All adults living, working, and/or volunteering in the home have obtained a criminal record clearance.

There were 1 deficiency cited on today's visit. See 809-D for deficiency.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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-andresources/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 809-C

SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa JacksonTELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: RIDDLE, MARY
FACILITY NUMBER: 013414465
VISIT DATE: 07/22/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Mary Riddle, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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 Riddle.

SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa JacksonTELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 07/22/2024 02:49 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612


FACILITY NAME: RIDDLE, MARY
FACILITY NUMBER: 013414465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 2 children did not have immunizations in their files which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/05/2024
Plan of Correction
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Licensee will submit both immunizations to LPA by email by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa JacksonTELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2024
LIC809 (FAS) - (06/04)
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