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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418519
Report Date: 11/29/2023
Date Signed: 11/29/2023 01:30:19 PM


Document Has Been Signed on 11/29/2023 01:30 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:PALASTI, ADRIENNE EFACILITY NUMBER:
013418519
ADMINISTRATOR:PALASTI, ADRIENNE EFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 427-2351
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY:14CENSUS: 8DATE:
11/29/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Adrienne Palasti- LicenseeTIME COMPLETED:
01:40 PM
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On 11/29/23, Licensing Program Analyst Briana Plumboy met with licensee Adrienne Palasti for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was 4 infants (1 whom is licensees son), 4 preschoolers, and 2 assistants (Andrea DeLa Torre and another assistant whom is under 18 years old). The home was toured to conduct a Health and Safety Inspection by LPA Plumboy and licensee. The facility currently operates Monday through Friday from 8:15am until 5:30pm.
The home is single story. The home has heating and ventilation for safety and comfort. The ON LIMIT AREAS are the living room, kitchen/dining room combination, the 2 bathrooms, the 1st room on the right upon entrance, and the room located next to the bathroom. The OFF LIMIT AREAS are the laundry room and the bedroom located next to the kitchen which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be the bedroom located next to the bathroom. The FRONTYARD play area is completely fenced. There is also a side yard connected to the front yard with a separate fence and canopy shade. There are toys and learning materials. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible during today's inspection.
The home has a fully charged 3A40BC fire extinguisher, smoke detector, carbon monoxide detector, first aide kit, and working telephone. Licensee has a valid CPR/First Aid certificate which expires 3/26/24 and assistant Andrea has a valid CPR/ First Aid certificate which expires 7/15/2025. The licensee Adrienne Palasti and assistant Andrea DeLa Torre is in compliance with the immunization law which pertains to providers. The licensee's mandated reporter training certificate expired on on 07/27/23 and Andrea received her mandated reporter training certificate on 8/7/23. There is a wall heater which is screened to prevent access by children and located inside the living room. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 9/28/23. The facility is in ratio today. All REQUIRED forms are posted and visible for public review. See 809-C for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: PALASTI, ADRIENNE E
FACILITY NUMBER: 013418519
VISIT DATE: 11/29/2023
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Incidental Medical Services (IMS) policy was discussed. 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

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, 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. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensee Adrienne Palasti 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 Adrienne Palasti 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.

A notice of site visit was given and must remain posted for 30 days.

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Adrienne Palasti.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC809 (FAS) - (06/04)
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