013422372-7-22-2022-02-CC-PDYR-CGL29M-20220722171209

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422372
Report Date: 07/22/2022
Date Signed: 07/22/2022 05:16:46 PM

Document Has Been Signed on 07/22/2022 05:16 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:	ALDERMAN, CATHERINE & TIM		FACILITY NUMBER:	013422372
ADMINISTRATOR:	ALDERMAN, CATHERINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 562-5681
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 5	DATE:	07/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:01 PM
MET WITH:	Catherine and Tim Alderman		TIME COMPLETED:	05:20 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	An unannounced Required - 1 Year inspection was conducted by Licensing Program Analyst L. Dyer. LPA arrived at the facility at 1:01 p.m. Licensees were present with 5 day care children (3 preschool-age and 2 infant). Facility is in compliance with licensed capacity and facility ratios. All adults meet criminal background clearance requirements. Phone number and e-mail address are current. Hours: 7:15 a.m. - 5:00 p.m. At 1:20 p.m., the following was observed: the day care area was inspected. Areas licensed for child care: living room/dining room/playroom, kitchen, hall and bathroom. Off-limit areas will be made inaccessible to children by closed and/or locked doors; gates; and visual supervision. The home was clean and orderly, with adequate heating and ventilation. There were a variety of books and toys for children's use. There were safe, healthful and comfortable accommodations, furnishings and equipment available to children at the time of this inspection. Facility has functioning cell phone, smoke detector, carbon monoxide detector, and fire extinguisher (3A:40:BC). Stairs inside the home are gated. Fireplace is blocked. There are no hazardous materials, medicines, or cleaning solutions accessible to children during this inspection. Hazardous items are kept in the garage, inaccessible to children. Licensee stated there were no firearms or bodies of water on the premises. Back yard area is securely fenced. Licensees have the backyard segmented into 4 quadrants. Children play in the upper right and lower right areas. The two left areas are off limits. Licensees have a child house, basketball net, rocking horse, riding toys, etc. for outdoor play. Licensee currently has 1 infant in care under 12 months of age, in which a sleeping plan is required. LPA discussed the safe sleep regulations with the licensee and discussed the Child Care Licensing Safe Sleep web page 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. (continued)

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

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: ALDERMAN, CATHERINE & TIM	FACILITY NUMBER: 013422372
	VISIT DATE: 07/22/2022

NARRATIVE

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There is an Individual Sleeping Plan for each infant up to 12 months of age, which is in the child's file. Signatures were reviewed. Documentation has been maintained for each 15 minute check. Licensee states infants have been supervised while sleeping, and is aware of the signs to be aware of: labored breathing, skin color, increase in body temperature and restlessness. Licensee states that infants sleep on their backs. There is no children with a Sleeping Plan with Section C in place. Licensee can visually observe when a child awakens from a nap. Play yards were reviewed for each infant up to 12 months of age. Placement did not hinder the entrance or exit to and from the sleeping space. Mattresses were firm, sized appropriately, and were covered with a tightly fitted sheet. There are no objects hanging above or attached to the play yard, and no bumper pads. Older children sleep on mats. Licensee states sheets are replaced when soiled or wet, and individual bedding is only used by one child only. Soiled bedding is placed in a closed container and is inaccessible until washed. Bedding is washed weekly or before used by another child or sent home to be washed.

LPA reviewed facility, children's and personnel records at 4:07 p.m. Licensee's Mandated Reporter Training expires 12/19/22. Licensees' CPR/First Aid expires 1/23/23. Last disaster drill completed on 6/22/22. All files are complete and all required postings are visible for public review. Facility roster was current. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall obtain a California clearance or criminal record exemption prior to working, residing or volunteering in a licensed facility.

Licensee Catherine Alderman 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 maximum per day/per person will be assessed if this regulation is violated. Licensee was also reminded of the Department's Inspection authority, and the need to comply when notified that termination of an employee is necessary.

Also discussed with the licensee: supervision of children at all times; children are not to be left in parked vehicles; car seats and high chairs; Unusual Incident Reporting; advertisements; changes in on-limit areas; construction work at facility; paying fees on-line; smoking; ill children in home, and the Guardian background check process. Ratios were discussed in detail.
(continued)

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

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: ALDERMAN, CATHERINE & TIM	FACILITY NUMBER: 013422372
	VISIT DATE: 07/22/2022

NARRATIVE

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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.

Important E-mail Addresses:
Community Care Licensing General Information and Updates:www.ccld.ca.gov.
Mandated Reporter Training:www.mandatedreporterca.com (Child Care Providers Module - required every 2 years).
Alameda County Public Health Department Website: www.acphd.org
Guardian: background check process with self-service options: https://www.cdss.ca.gov/inforesources/ cdss-programs/community-care-licensing/caregiver-background-check/guardian

NO DEFICIENCIES CITED 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.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

LIC809 (FAS) - (06/04)

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