013421865-1-15-2020-52-CC-JCHN-BKURWP-20200115122329

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421865
Report Date: 01/15/2020
Date Signed: 01/15/2020 12:23:36 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:	AYCHILUHIM, TEGEST		FACILITY NUMBER:	013421865
ADMINISTRATOR:	AYCHILUHIM, TEGEST		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 200-1956
CITY:	SAN LEANDRO	STATE: CA	ZIP CODE:	94577
CAPACITY:	14	CENSUS: 10	DATE:	01/15/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Tegest Aychiluhim		TIME COMPLETED:	12:45 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	At 10:45AM, Licensing Program Analyst (LPA) Junell Chen and Licensing Program Manager Jason Jang arrived for an unannounced Annual/Random Inspection, and met with Licensee Tegest Aychiluhim. Present were ten preschoolers. Also present during the inspection were fingerprint cleared assistants Marta Ucbaindirias and Colette Kontchou. Not present during the inspection were Licensee's two children; one daughter and son and fingerprint cleared husband Mekuanint Mengiste. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 7:00am to 5:30pm. ON LIMITS: The main daycare area which consists of the main daycare room, daycare napping room, two bathrooms, kitchen, dining area, front enclosed outside area, and backyard. OFF LIMITS: The main living quarters of the home separate from the main daycare rooms and the garage. The home is a two level, which consists of five bedrooms, two and half bath, which are neat and clean, with heating and ventilation for safety and comfort. The isolation area will be the nap room. There were ample age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. Carbon monoxide and smoke detector meet State Fire Marshall standards. There exists a fully charged 3A40BC fire extinguisher. Per licensee, there is central heating to the facility. Per licensee, there are no firearms in the home. There are no pets in the home. All required licensing documents are posted and visible for public review. *See LIC809C for Continuance*

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Junell Chen	TELEPHONE: (510) 622-4035
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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: AYCHILUHIM, TEGEST	FACILITY NUMBER: 013421865
	VISIT DATE: 01/15/2020

NARRATIVE

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During the time of inspection, 2 children's files were reviewed, 2 staff files and facility file reviewed. The facility roster was presented and a copy obtained. The licensee is in ratio today. The licensee's Pediatric CPR/First Aid certificate is current and expires 02/20/2020. Last disaster drill was logged on 11/03/19.

Mandated Reporter training was completed on 09/26/2019 for the Licensee. Licensee does have proof of immunization records. Safe Sleep practices were discussed, and new car seat laws were provided. Licensee was reminded that children are never to be left in a parked vehicle.

No deficiencies were cited today.

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 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 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.

This report shall remain on file for 3 years. A Notice of Site visit was given at time of inspection and requested Licensee to post the Notice in a unobstructed, viewable area for 30 days. Exit interview conducted with Licensee Tegest Aychiluhim. Copy of report provided.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Junell Chen	TELEPHONE: (510) 622-4035
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

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