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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416631
Report Date: 06/07/2023
Date Signed: 06/07/2023 11:44:05 AM


Document Has Been Signed on 06/07/2023 11:44 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:MARIN, THANIAFACILITY NUMBER:
013416631
ADMINISTRATOR:MARIN, THANIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 841-1043
CITY:BERKELEYSTATE: CAZIP CODE:
94703
CAPACITY:11CENSUS: 7DATE:
06/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Thania MarinTIME COMPLETED:
11:35 AM
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On June 7th, 2023, approximately 9:25am, Licensing Program Analyst (LPA) April Wright met with licensee Thania Marin for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during inspection were seven (7) children ( 3 preschool age / 4 infants) and fingerprint cleared mother/assistant Blanca Betancourth. Hours of operation are 8am - 5pm Monday through Friday.

LPA toured the facility to conduct a health and safety inspection. The single-story home was neat and orderly, with heating and ventilation for safety and comfort of children in care. The home consists of two bedrooms, two bathroom, living room, dining area, kitchen and laundry area. There is a in-law unit in the rear of the home. (entrance in backyard). The isolation area is the living room on the couch which is a section away from other children in care.

On limit areas include: Living / Dining room area, bathroom, and portion of backyard (gated).
Off-limits areas include: Both bedrooms, in-law unit, remaining portion of backyard, kitchen and shed.

The off limits are and will be made inaccessible by closed and/or locked doors and visual supervision. There are age appropriate toys that appear to be safe and in good condition. There are child safety gates in place to prevent access to the off limits areas of the home. There are no pools hot tubs or any other bodies of water present in the on-limit areas during today’s inspection. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection.

The home has a three (3) fully charged 2A10BC fire extinguishers, working smoke/carbon monoxide detectors, fully stock First Aid Kit. and telephone. There is a fireplace and floor vents that are blocked/not in use and inaccessible to children in care. Per licensee there are no firearms in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers.
See LIC809 -C for continuance
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2023
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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: MARIN, THANIA
FACILITY NUMBER: 013416631
VISIT DATE: 06/07/2023
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LPA requested and reviewed the files of seven (7) children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The facility roster was review and copies were obtained. The licensee conducts fire and disaster drills twice a year and the last was conducted on 2/3/2023. The licensee has a current CPR/First aid certificate which expires on 6/2024 and Mandated reporter training which was completed on 10/26/2021. The licensee is in of ratio today. All required forms are posted and visible for public review.

Incidental Medical Services (IMS) policy was discussed. IMS IS PROVIDED AT THIS FACILITY (Epipen - one child). For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 Child Care Licensing Safe Sleep webpage 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.


California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented. The licensee is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates The licensee is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.See LIC809 C for continuance.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: MARIN, THANIA
FACILITY NUMBER: 013416631
VISIT DATE: 06/07/2023
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Licensee was reminded that all adults 18 and over, 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 childcare center. 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.

There are no deficiencies cited. A notice of site visit was given and must remain posted 30 days. Exit interview conducted and report was reviewed with Licensee Thania Marin.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
LIC809 (FAS) - (06/04)
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