013418033-2-24-2022-52-CC-EWOS-CBXPZN-20220224104548

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013418033
Report Date: 02/24/2022
Date Signed: 02/24/2022 10:45:56 AM

Document Has Been Signed on 02/24/2022 10:45 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
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: 7	DATE:	02/24/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Hortensia Sowunmi		TIME COMPLETED:	11:00 AM

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 Analyst (LPA) Elimika Woods met with licensee Hortensia Sowunmi 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 the inspection were seven (7) preschool age children. Licensee stated that the facility operates from Monday to Friday 7:00 AM to 6:00 PM. LPA toured the facility to conduct a Health and Safety inspection. This two story home was clean and orderly, with heating and ventilation for the safety and comfort of children in care. On-limit-areas include: Living room, dining area, family room, backyard, and converted garage Off-limit-areas include: Kitchen, entire second level of home The home is two story, which consists of four bedrooms, two baths, kitchen, living and dining room, family room, and backyard. The off- limits area is made inaccessible by closed and/ or locked doors and visual supervision. There's a gate at the bottom of the stairs to prevent children 5 years of age access. The ISOLATION AREA will be the living room away from children in care. LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during today inspection. There are ample age appropriate toys, learning materials, and equipment that appear to be safe and in good condition. The home has a fully charge 3A40BC fire extinguisher, dual working smoke detector/carbon monoxide detector, working telephone and first aid Kit. The fireplace is blocked to prevent access by children. The licensee’s Health and Safety training is completed, and CPR and First Aid certificate is current and expires 05/2023. The licensee completed and received a certificate in mandated reporter training on 10/25/2020. Per licensee there are no firearms stored at the facility. See 809-C for continuance

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022

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: 02/24/2022

NARRATIVE

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The OUTDOOR PLAY area is the fully fenced backyard and LPA observed that it is free from defects or dangerous conditions. During today's inspection, there are no play structures which are required to be anchored and there's a slide that has cushioning to absorb falls.

At 9:00 AM LPA requested and reviewed the file of three (3) children in care. All files contained Identification & Emergency, Parent's Rights, and Medical Consent forms. The facility roster was reviewed, and copies were obtain. The licensee conducts and documents fire and disaster drills at least twice a year, and the log indicates a drill was conducted 01/10/2022. The licensee is in ratio today. All required forms are posted and visible for public review.

California Law requires Family Child Care Home 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 624B). 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.

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

LPA informed the licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee was also reminded that CPR/First Aid is renewed every two years. Mandated Reporter Training is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

See 809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022

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: 02/24/2022

NARRATIVE

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The licensee is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. The licensee was provided information regarding effects of Lead Exposure and testing requirements (Assembly Bill 2370).

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-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.

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

There are no deficiencies cited. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Hortensia Sowunmi.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022

LIC809 (FAS) - (06/04)

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