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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416911
Report Date: 02/06/2020
Date Signed: 02/06/2020 03:29:39 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:FAGEL, IVETTEFACILITY NUMBER:
013416911
ADMINISTRATOR:FAGEL, IVETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 865-1750
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:14CENSUS: 7DATE:
02/06/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Ivette FagelTIME COMPLETED:
03:40 PM
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On 02/06/2020 at 02:15 PM Licensing Program Analysts (LPAs) Arminder Singh and Monica Mathur met with the licensee Ivette Fagel and assistant Denisse Maravilla for an unannounced required inspection. There are 7 children (4 preschool children and 3 infants) present. Days and hours of operation are Mon - Fri, 7:30 AM to 5:00 PM.

At 2:25 PM 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, family room, dinning room, kitchen, 3 bedrooms, 2.5 bathrooms, attic, basement, garage, unfenced front yard, fenced back yard which includes a shed(locked) and patio area. The ON LIMIT are the living room, dining room, and kitchen. The OFF LIMITS areas are the 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. OFF LIMITS which will be inaccessible by closed and or/locked doors and visual supervision. There are ample age appropriate toys that appear to be safe and in good condition. Licensee takes the children to the neighborhood park for outdoor play. There are no pools, hot tubs, or any other bodies of water.

The home has a fully charged 2A10BC fire extinguisher, working smoke detector, and carbon monoxide detector. There is centralized heating that is working and in good repair. Licensee states there are no firearms in the home. Licensee does have a pet dog. The family room is the isolation room. She has a first aid kit.

Licensee and assistant have current Pediatric CPR and First Aid certificates. Licensee's certificate expires on 11/16/2021 and assistant on 06/2021. Mandated reporter training are current. At 03:00 PM one child's file who is newly enrolled was reviewed and is complete.

Please see LIC 809 C for additional information
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Arminder SinghTELEPHONE: (510) 622-2634
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020
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: FAGEL, IVETTE
FACILITY NUMBER: 013416911
VISIT DATE: 02/06/2020
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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.
REMINDERS/RESOURCES
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

- LPAs provided Lead Poisoning Information Flyer.

Licensee is reminded that while children are going to the park that there should be 100% supervision.

-LPA's advised licensee to send updated Child Care Facility Roster by 02/07/2020.

· Licensees and all staff are Mandated Reporters and are required to report to CCLD any suspected child abuse. Mandated reporters are valid for two years after completion.

CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov or send email Child Care Advocate Program.

No Deficiency was cited during today's visit.

At 03:25 PM exit interview was conducted. A NOTICE OF SITE VISIT was issued and must
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Arminder SinghTELEPHONE: (510) 622-2634
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020
LIC809 (FAS) - (06/04)
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