013422271-5-4-2022-02-CC-DCAS-CE4VN2-20220504163425

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422271
Report Date: 05/04/2022
Date Signed: 05/04/2022 04:34:32 PM

Document Has Been Signed on 05/04/2022 04:34 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	LEON, IRMA		FACILITY NUMBER:	013422271
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 8	DATE:	05/04/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Irma Leon		TIME COMPLETED:	04:45 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 05/04/2021, Licensing Program Analyst (LPA) Diana Campos conducted an in-person case management/increase in capacity inspection. Present during today's inspection were the licensee, licensee's adult daughter who assists with day care and eight children in care consisting of 2 infants, 4 preschoolers and 2 school age children. The entire home was toured to conduct a health and safety inspection with the licensee. Hours of operation for day care are Monday through Friday 7:30am to 5:30pm. Community Care Licensing (CCL) has received an approved fire clearance on 04/01/2022 by the Oakland Fire Department. The home is a 2 story house which is neat and clean with heating and ventilation for the safety and comfort of the children. The home consists of living room, dining room, three bedrooms, kitchen, one bathroom, basement, laundry room and backyard. The on limits areas are the Living room, dining room, all three bedrooms, bathroom, and backyard. Two additional bedrooms have been added to licensee's on limit areas. Both bedrooms were inspected by LPA for health and safety inspection. The off limits area are, the basement/laundry room and the fenced off rear portion of yard. Off limit areas will be made inaccessible by use of gates, closed and/or locked doors and visual supervision. There are age appropriate toys in the home. The isolation area will be the bedroom adjacent to the kitchen. Per licensee, there are no firearms in the home. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector and carbon monoxide detector, first aid supplies and working telephone. ------------See 809-C for continuance----------------------------------------------------------------------

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LEON, IRMA	FACILITY NUMBER: 013422271
	VISIT DATE: 05/04/2022

NARRATIVE

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The applicant’s CPR and First Aid certificate is current and expires 03/2023. Licensee's Mandated Reporter training certificate is current and expires 4/2023. Licensee is in compliance with immunization requirements. Safety precaution in regards to COVID-19 were discussed and posters were posted on front door.

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

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.

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.

No deficiencies observed at this visit. The licensee is now approved for an increase in capacity to operate as a large family day care home.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Irma Leon.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

LIC809 (FAS) - (06/04)

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