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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421013
Report Date: 05/29/2019
Date Signed: 05/29/2019 09:41:22 AM

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:CODD, AYDEEFACILITY NUMBER:
013421013
ADMINISTRATOR:CODD, AYDEEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 889-9221
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY:14CENSUS: 10DATE:
05/29/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Aydee CoddTIME COMPLETED:
09:50 AM
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On 05/29/19, Licensing Program Analyst Briana Plumboy, met with licensee Aydee Codd for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was licensees finger print clear husband Frank Codd, finger print clear assistant Conception Palacios Ticas, 1 infant, and 9 preschool age children. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:30am until 6:00pm.
The home is a four level home. The ON LIMIT AREAS are the lower two levels of the home, except the garage, the closet on the lower level, and laundry room. The on limit areas include the bottom level room, the bedroom located across from the bathroom, and the bathroom. The OFF LIMIT AREAS are the two upper levels which will be inaccessible by closed and/or locked doors and visual supervision. There are barricades located on each level of the stairs to prevent access to children under 5 years old. The ISOLATION AREA will be the sleeping area by the entrance to the day care. To enter the childcare, there is a gate located on the side of the home. The BACKYARD play area is completely fenced. The backyard has a pool which has been completely filled with tanbark and converted into a playground area. There are stairs located in the backyard and have a barricaded gate at the bottom to prevent access. Licensee is aware if toys are broken or not in the manufactures intended form, they must be restored to the manufactures intent, replaced, or removed from the childcare areas of the home. There are ample age appropriate toys and learning materials.
The home has a working smoke detector, working carbon monoxide detector, working telephone, and First Aid Supplies. The licensee CPR and First Aid certificate is current and expires 04/20/21, and the assistant Ms. Conception's expires 10/08/18. Aydee Codd and Conception Palacios Ticas are in compliance with the immunization law which applies to providers. Aydee Codd and Conception Palacios Ticas are in compliance with the mandated reporter training law. Conception Palacios Ticas received her certificate on 04/20/21, and Aydee Codd received her certificate on 03/18/18. Per licensee, there are no firearms in the home. The licensee Aydee Codd, conducts and documents fire and disaster drills twice a year with the last one conducted on 04/13/19.
Facility roster reviewed and copy obtained. The licensee 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) 622-2593
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019
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: CODD, AYDEE
FACILITY NUMBER: 013421013
VISIT DATE: 05/29/2019
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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

LPA Plumboy provided a copy of Safe Sleep Regulation Concept to the licensee

The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility.

Effective August 1, 2003 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 624). 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.

The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day 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. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list


There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019
LIC809 (FAS) - (06/04)
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