013421222-1-27-2023-52-CC-RHAR-CNGUF9-20230127143221

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421222
Report Date: 01/27/2023
Date Signed: 01/27/2023 02:32:28 PM

Document Has Been Signed on 01/27/2023 02:32 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	ERENO, JO ANNA		FACILITY NUMBER:	013421222
ADMINISTRATOR:	ERENO, JO ANN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 896-8952
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY:	14	CENSUS: 9	DATE:	01/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Jo Anna Ereno		TIME COMPLETED:	02:45 PM

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	On January 27, 2023 at approximately 12:20pm Licensing Program Analyst (LPA) Russ Haderer met with licensee Jo Anna Ereno for the purpose of conducting an unannounced annual inspection for health and safety. Present for the inspection was the licensee, 1 TB and fingerprint cleared assistant and 9 children in care (1 infants and 8 toddlers). The facility is in ratio today. The hours of operation are Monday-Friday, 7:30am to 5:30pm. The facility is a single story 3-bedroom, 2-bathroom home with an attached two-car garage. It is rented by the licensee and contains a dining room, kitchen, living room, three bedrooms and two bathrooms, an enclosed (fenced) back and side yard areas and a separate courtyard area between the living room and one bedroom, and a small driveway area in the front of the home. The home is neat and clean with heating and ventilation for safety and comfort. On-limit-areas include: The living room (day care area), dining room, kitchen, first bedroom on the right side of hall for napping, the house bathroom, large back yard patio just off the kitchen. Off-limit-areas include: The bedroom on the left side of the hall, master bedroom and bathroom, attached two car garage and the courtyard area between the living room and the first bedroom on the right; the side yard on the west side. There are two locked sheds in the off limits area. The off-limit areas will be inaccessible by closed and/or locked doors, and/or by child supervision. Toxins, medicines, and hazardous items were inaccessible during today's inspection. There is a fireplace in the living room (day care area) that is fully blocked off by a large wooden cubby structure for children’s toys. Per licensee, there are no firearms in the home.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

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: ERENO, JO ANNA	FACILITY NUMBER: 013421222
	VISIT DATE: 01/27/2023

NARRATIVE

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There is a fully charged 2A10BC fire extinguisher located in the kitchen, The facility has working (tested and functioning) smoke and carbon monoxide detectors. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 11-07-2022. All required licensing documents are posted and visible for public review.

Children's files were reviewed and found to be complete and well organized. The facility roster was reviewed, and a copy obtained. All files were organized and complete. The licensee rents the property, does not carry liability insurance. LIC282 forms signed and dated in each child’s file. Sleep logs were available and maintained for all infants 0-24 months in age. One child in care requires an EpiPen for any allergic reaction, all forms and plan of action was available and the medication was checked and not expired. Staff files were reviewed, all files were complete and well organized.

The licensee’s and helper’s Pediatric CPR/First Aid certificate is current and expires 6/5/2023 assistant’s 6/5/2023. Mandated reporter training was completed (licensee on 6/2/2022, helpers done 6/9/2022). LPA reminded the licensee of the following: Mandated Reporter certificate and, CPR/First Aid must be renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.

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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

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: ERENO, JO ANNA	FACILITY NUMBER: 013421222
	VISIT DATE: 01/27/2023

NARRATIVE

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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.

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 were no deficiencies issued today.

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

Exit interview conducted and report was reviewed with the licensee Jo Anna Ereno.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

LIC809 (FAS) - (06/04)

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