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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422117
Report Date: 06/04/2019
Date Signed: 06/04/2019 11:42:51 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:REED, ALICIAFACILITY NUMBER:
013422117
ADMINISTRATOR:REED, ALICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 359-2460
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY:14CENSUS: 13DATE:
06/04/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Alicia ReedTIME COMPLETED:
12:00 PM
NARRATIVE
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On 06/04/19, Licensing Program Analyst Briana Plumboy met with licensee Alicia Reed for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was 4 infants, 9 preschool age children, and assistant Masooda Jafari. The home was toured to conduct a Health and Safety Inspection. The facility operates from 7:00am until 6:00pm.

The home is single story. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the side entrance addition room, the main play room, last bedroom located on the left side of the hallway, the living room, kitchen, backyard, and hallway bathroom. The OFF LIMIT AREAS are the detached garage and remaining bedrooms which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be the living room. The BACKYARD play area is fenced. There is a anchored play structure which has cushioning underneath. There are ample age appropriate toys that are in good condition. There are no pools, hot tubs or any other bodies of water present in the on limit areas during today's inspection. At 9:01am, a preschool age child arrived at the facility which placed the licensee out of ratio. Also, LPA Plumboy observed an infant holding his bottle inside a bouncer. A bouncer is not permitted inside a daycare. The licensee utilizes form Lic.282.

The home has a fully charged 2A10BC fire extinguisher, working smoke detector, carbon monoxide detector, and working telephone. The licensee CPR and First Aid certificate is current, and her assistant C.Melendez's certificate expires 04/22/2020. The licensee and her assistant Cassidy are in compliance with the immunization law. The assistant present today does not have the required provider immunization's present for review. There is a gated wall heater located in the additional room for childcare. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last fire drill documented on 02/14/19 and the last earthquake drill documented on 02/19/19. See 809-C for continuance and 809-D for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 6
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: REED, ALICIA
FACILITY NUMBER: 013422117
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/28/2019
Section Cited
CCR
102417(g)(10)
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Operation of a Family Child Care Home. A baby bouncer is not permitted on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).
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By 06/28/19, licensee shall watch the Personal Rights video on the ccld.ca.gov website. During the inspection, the licensee removed the infant from the baby bouncer and placed the bouncer in an off limits area. The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care.
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This requirement is not met as evidenced by:
Based on observation, there is an infant drinking a bottle inside a bouncer. Bouncers are not permitted which poses a potential health and safety risk to children in care.
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Licensee is being assessed $250 CIVIL PENALTY today for a repeat violation from 08/01/19, and $100 per day until corrected.
Type B
06/28/2019
Section Cited
HSC
1597.622(a)(1)
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Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and
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On or before 06/28/19, the licensee stated she will provide LPA Plumboy with a copy of her assistant's REQUIRED immunizations via email, text, post, or fax.
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measles.
THE ASSISTANT DOES NOT HAVE THE REQUIRED IMMUNIZATIONS FOR PROVIDERS TODAY WHICH POSES A POTENTIAL RISK TO CHILDREN IN CARE.
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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.
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: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: REED, ALICIA
FACILITY NUMBER: 013422117
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/05/2019
Section Cited
CCR
102416.5(a)
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102416.5(a) Staffing Ratio and Capacity. The capacity specified on the license shall be the maximum number of children for whom care can be provided.
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Licensee is to immediately reduce numbers to within capacity specified on license and watch the ratio/capacity video on the ccld.ca.gov website. Licensee must send LPA Plumboy an email as soon as her facility is in compliance to stop civil penalty.
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This requirement is not met as evidenced by:
Based on observation, a physical census, and interview, facility is out of ratio today with 4 infants and 9 preschool age children in care which poses an immediate health and safety risk to children in care.
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 LPA to revisit to ensure Licensee is remaining within RATIO. Licensee is being assessed $250 CIVIL PENALTY today for a repeat violation from 08/01/18, 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: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: REED, ALICIA
FACILITY NUMBER: 013422117
VISIT DATE: 06/04/2019
NARRATIVE
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For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list

Today the licensee is cited for the following:
1) Out of ratio- Type A with $250 repeat violation civil penalty
2) Usage of a baby bouncer- Type B with $250 repeat violation civil penalty
3) Staff immunization's are missing for assistant M.Jafari- Type B
4) The children's roster is not current- Type B
5) Children C1, C4, C5, C8, and C10, are missing their immunization records- Type B

The attached Type A deficiency is cited today for Ratio. Upon receipt, licensee shall post for 30 days and provide copies of this licensing report to parent/guardians of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 Acknowledgement of Receipt of Licensing Reports should be signed by guardians and placed in each child’s file. LPA Plumboy provided licensee with copies of Lic. 9224 for both current children in care and newly enrolled children in care.

See (3)809-D's for deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and appeal rights provided.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: REED, ALICIA
FACILITY NUMBER: 013422117
VISIT DATE: 06/04/2019
NARRATIVE
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Facility roster is not current today. The licensee is out of ratio today.

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

See 809-C and 809-D for continuance

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: REED, ALICIA
FACILITY NUMBER: 013422117
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/28/2019
Section Cited
CCR
102417(g)(8)
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Operation of a Family Child Care Home. All homes shall have a current roster of the children.
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Licensee shall update the children's roster and submit a copy to licensing by due date of 6/28/19.
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This requirement is not met as evidenced by:
Based on observation and interview, facility does not have an updated roster, which poses a potential health and safety risk to children in care.
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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.
Type B
06/28/2019
Section Cited
CCR
102418(g)
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Immunization. Licensee shall document and maintain each child’s file immunizations as long as the child is enrolled.
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Licensee shall obtain immunization records for C1, C4, C5, C8, and C10 and submit copy of children's immunization records and cards to LPA by 06/28/19.
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This requirement is not met as evidenced by: Based on observation, 5 children's files do not have immunization cards, which poses a potential health and safety risk to children in care.
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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.
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: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019
LIC809 (FAS) - (06/04)
Page: 6 of 6