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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420502
Report Date: 03/04/2022
Date Signed: 03/04/2022 10:50:58 AM


Document Has Been Signed on 03/04/2022 10:50 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:STOLL, DAINELLEEFACILITY NUMBER:
013420502
ADMINISTRATOR:STOLL, DAINELLEEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 922-9494
CITY:PLEASANTONSTATE: CAZIP CODE:
94588
CAPACITY:14CENSUS: 0DATE:
03/04/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Dainellee Stoll TIME COMPLETED:
11:05 AM
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On March 3, 2022 Licensing Program Analyst (LPA) Lorraine Dacanay Breaux met with licensee Dainellee Stoll for the purpose of conducting an unannounced 1-year annual inspection. Living in the home is the licensee, fingerprint cleared husband and under age 18 son. Present in the home for today’s inspection was the licensee, husband, 0 children were in care. (child care is closed today). The hours of operation will be Monday - Friday, 8:00 AM to 2:00PM

The home is a one story home and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the living room, formal dining room, garage, family room, backyard, first bathroom to the left in the hallway, and the bedroom directly across the hallway bathroom. The OFF LIMIT AREAS are the three remaining bedrooms, all of which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA is the living room. The backyard is fenced. There are toys and learning materials in the facility. There are no pools, hot tubs, ponds, or any other bodies of water in the on-limits areas during this inspection. Off-limit areas will be inaccessible by closed and/or locked doors, child gates and/or by supervision.

Per licensee there are firearm in the home. Detergents, cleaning compounds, medications and other items which could pose a danger to children are stored and inaccessible to children. Licensee has ample age-appropriate toys and learning materials inside and outside that were observed to be safe and in good condition. The home has a fully charged 3A40BC fire extinguisher. Dual smoke/carbon monoxide detector and a working telephone.

LPA requested and reviewed the files of 2 (two) children in care. All files contained Immunization, 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 twice a year with the last one conducted on 02/07/2022. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires 12/18/2023. The licensee has completed mandated reporter training and the certificate expires 02/17/2024. All required forms are posted and visible for public review.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 03/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/04/2022
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: STOLL, DAINELLEE
FACILITY NUMBER: 013420502
VISIT DATE: 03/04/2022
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LPA reminded 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.

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

Licensee [or facility representative] 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.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022
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: STOLL, DAINELLEE
FACILITY NUMBER: 013420502
VISIT DATE: 03/04/2022
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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, Dainellee Stoll
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022
LIC809 (FAS) - (06/04)
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