013418033-9-10-2019-52-CC-LDYN-BFVUHM-20190910153611

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013418033
Report Date: 09/10/2019
Date Signed: 09/10/2019 03:36:17 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SOWUNMI, HORTENSIA		FACILITY NUMBER:	013418033
ADMINISTRATOR:	SOWUNMI, HORTENSIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 889-8499
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	14	CENSUS: 6	DATE:	09/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Hortensia Sowunmi		TIME COMPLETED:	03:45 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	On 9/10/19 at 2:10pm, Licensing Program Analyst (LPA) Loretta Dyson arrived at the home for an unannounced random inspection. LPA met with the licensee. The licensee's fingerprint cleared spouse was also present. There were 2 infants and 4 preschool age children also present. At 2:25pm, LPA toured the areas inside of the home that are used for the child care, which include the family room, downstairs bathroom, and the converted garage. All other areas of the home are off limits, and made inaccessible by gate, closed and/or locked doors and visual supervision. The isolation area will be a section of the family room, away from other children in care. LPA observed that the areas used for the child care are neat and clean, and the home has sufficient heating and ventilation for the safety and comfort of children in care. There are an ample supply of toys and activities, which are age appropriate, safe and in good condition. There is a gate for the stairs to prevent access by children. The fireplace is blocked to prevent access by children. The fenced backyard is used for outdoor play, and LPA did not observe any defects of dangerous conditions in this area. LPA did not observe any bodies of water, hazardous items or toxins accessible to children today. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and earthquake drills twice a year, and the last drills were conducted in July 2019. The home has a fully stocked first aid kit, working telephone, working carbon monoxide detector, working smoke detector and fully charged 3A40BC fire extinguisher. The Hayward Fire Department conducted an inspection of the home on 1/15/19. LPA reviewed the files of 2 children in care. The licensee's CPR/first aid certificates are current and expire on 4/9/21. The licensee has a certificate of completion for the required mandated reporter training, dated 11/12/18. Her assistant has a certificate of completion for the required mandated reporter training, dated 3/18/19, and her CPR/first aid certificates expire on 9/28/20. All required forms are posted and visible for public review. continued on 809C

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: SOWUNMI, HORTENSIA	FACILITY NUMBER: 013418033
	VISIT DATE: 09/10/2019

NARRATIVE

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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. The licensee stated that there are no children enrolled at this time, who require medication while in care.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. LPA reviewed the individuals associated to the license, and the licensee confirmed that everyone who is required to have a criminal record clearance is associated. Licensee was reminded of the responsibility as a mandated reporter. The licensee was reminded that the mandated reporter training needs to be renewed every 2 years, at www.mandatedreporterca.com.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to sign up to receive quarterly updates by email by sending a request to ChildCareAdvocatesProgram@dss.ca.gov. The Licensee was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet.

There are no deficiencies cited. This report shall remain on file for 3 years. A Notice of Site visit was given to licensee, and licensee was reminded that it is required to be posted for 30 days. An exit interview was conducted with the licensee.

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

LIC809 (FAS) - (06/04)

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