013420236-1-23-2020-52-CC-EWOS-BL4US4-20200123144942

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013420236
Report Date: 01/23/2020
Date Signed: 01/23/2020 02:49:51 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:	BROWNLEE, DARLENE		FACILITY NUMBER:	013420236
ADMINISTRATOR:	BROWNLEE, DARLENE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 470-3887
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	14	CENSUS: 4	DATE:	01/23/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Darlene Brownlee		TIME COMPLETED:	03:15 PM

NARRATIVE

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On 01/23/2020, at approximately 11:35 AM, Licensing Program Analyst Elimika Woods (LPA) met with licensee Darlene Brownlee, to conduct an unannounced Annual Random Inspection. Present during the inspection was licensee, three preschool aged children, licensee's infant grandson, and licensee's fingerprint cleared daughters, Elayjah and Dysha Brownlee. LPA Woods conducted a Health and Safety Inspection with the licensee. Licensee stated hours of operation are twenty-three (23) hours a day ., Monday through Sunday.

On-limit-areas are the: Kitchen, living, bathroom in the hallway of the top floor, the first bedroom on the right side of the main hallway, bedroom on the left side of hallway and child care room

Off-limit-areas are the: Bedroom next to the child care room, licensee's bedroom and bathroom, and garage

This home is a two-story home, which consists of four bedrooms, two bathrooms, the living room, child care room, backyard, and garage. The home is neat and clean with heating and ventilation for safety and comfort. The off-limits are will be made inaccessible by closed and/or locked doors and visual supervision. The Isolation area will be a section of the living room away from other children in care. The outdoor play area is the fenced backyard. LPA advised the licensee to have 100% visual supervision while children are in the yard because some of the boards on the deck have been patched up and could pose a tripping hazard. The licensee advised that she also utilizes the local park. The licensee was reminded to have 100% supervision when away from the home with children. There are no pools, hot tubs or any other bodies of water present in the on-limit areas during today's inspection. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. The home has a fully charged 3A40BC fire extinguisher, smoke detector, carbon monoxide detector, and telephone. Both the licensee and her assistants have current CPR and First Aid certificate which expires 01/05/2021.

The licensee conducts and documents fire/disaster drills at least twice a year, and log indicates a drill was conducted on 07/10/19. Per licensee, there are no firearms in the home. There are no heaters accessible to children, and the fireplace is blocked to prevent access by children. All required forms are posted and visible for public review. The licensee is in compliance with the immunization laws which pertains to all childcare providers. A facility roster was reviewed and copy obtained.

See 809-C for continuation

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: BROWNLEE, DARLENE	FACILITY NUMBER: 013420236
	VISIT DATE: 01/23/2020

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At 12:00 PM, LPA Woods requested to review two (2) children’s facility files. Each file contained completed Identification & Emergency forms, Immunization documents, and Medical consent forms.

Incidental Medical Services (IMS) -Per the licensee, there are no children on any form of medication. The licensee is not providing IMS currently.

LPA reminded the licensee of the following; Mandated Reporter training is to be renewed every two years, CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. LPA discussed Unusual Incidents Reports.

The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing.

The licensee was 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. The licensee was reminded of the responsibility as a mandated reporter.

The licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet.

See 809 D

A notice of site visit was given to the Licensee and the Licensee was reminded that it is required to be posted for 30 days. This report shall remain on file for 3 years. Exit interview conducted and appeal rights provided.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

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: BROWNLEE, DARLENE	FACILITY NUMBER: 013420236
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/23/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/23/2020 Section Cited	1 2 3 4 5 6 7	On or before March 30, 2018, a person on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a)
	8 9 10 11 12 13 14	This requirement has not been met as evidenced by LPA’s review of files, in which the licensee does not have a certificate of completion of the required mandated reporter training for herself and her assistants. This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14	Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

LIC809 (FAS) - (06/04)

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