013416911-12-12-2019-02-CC-ASIH-BJSQUL-20191212112856

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013416911
Report Date: 12/11/2019
Date Signed: 12/12/2019 11:29:03 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:	FAGEL, IVETTE		FACILITY NUMBER:	013416911
ADMINISTRATOR:	FAGEL, IVETTE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 865-1750
CITY:	ALAMEDA	STATE: CA	ZIP CODE:	94501
CAPACITY:	14	CENSUS: 6	DATE:	12/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Ivette Fagel		TIME COMPLETED:	04:40 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	Licensing Program Analysts Arminder Singh and Caroline Colson met with the licensee Ivette Fagel and assistant Denisse Maravilla for an unannounced random annual inspection at 2:25 PM. There are 4 preschool children and 2 infants present. One (1) child's records was reviewed by the LPA's and the licensee on 12/11/19 at 2:45 PM. C1 has a complete file. S1 has a complete file. The Licensee stated to the analyst that there are no additional records available in the facility. The home was toured to conduct a health and safety inspection. The home is a two story home. The home consists of a living room, second living room, dinning room, kitchen, 3 bedrooms, 2.5 bathrooms, attic, basement, garage, unfenced front yard, fenced back yard which includes a shed and patio area, The off limit areas are unfenced front yard, fenced backyard which has shed and patio area, first bedroom close to the entrance of home, basement, the entire second floor which includes the attic and bedroom. The home has a 2A10BC fire extinguisher and a working smoke and carbon monoxide detector. There is a working heater in the home. Licensee states there are no firearms in the home. The front living room is the isolation room. She conducts fire/disaster drills every six months. Her infant CPR and First Aid certificates are current and expire on June 22, 2021. She has a first aid kit. There is a pet dog. Licensee takes the children to the neighborhood park for outdoor play. This facility is not providing Incidental Medical Services - IMS at this time. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family child care home evaluator manual (FCCH EM) Policy 102417. Please LIC 809 C for additional information

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) -62-2591
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 622-2634
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2019

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: FAGEL, IVETTE	FACILITY NUMBER: 013416911
	VISIT DATE: 12/11/2019

NARRATIVE

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Criminal Background Clearance: All assistants, volunteers, frequent adult visitors (adults are individuals 18 years of age or older) must be fingerprint cleared and associated to the facility prior to be in the presence of children in care. Failure to comply, requires an immediate civil penalty of $100 to $3000 per person, per incident.

· CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

· NEW LAW: Safe Sleep Regulations: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

· Licensees and all staff are Mandated Reporters and are required to report to CCLD any suspected child abuse.

CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov

· Licensees may register to receive child care updates: www.myccl.ca.gov

The mandated reporter training was discussed and needs to be completed every two years.
Analyst reviewed required documents for all children's records, beverage law requirements for children in care and diaper changing procedures were discussed.

There were no deficiencies cited during this inspection.

A site notice was posted. An exit interview was conducted. Appeal rights were discussed. This report must remain available for public review for 3 years.

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) -62-2591
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 622-2634
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019

LIC809 (FAS) - (06/04)

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