013422829-4-22-2024-52-CC-EWOS-D4KSDE-20240422134700

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422829
Report Date: 04/22/2024
Date Signed: 04/22/2024 01:47:10 PM

Document Has Been Signed on 04/22/2024 01:47 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	RANDALL, PAMELA		FACILITY NUMBER:	013422829
ADMINISTRATOR:	RANDALL, PAMELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 213-5166
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	14	CENSUS: 3	DATE:	04/22/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Pamela Randall		TIME COMPLETED:	02:05 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 April 22, 2024, at 12:15 PM, Licensing Program Analyst (LPA) Elimika Woods met with licensee Pamela Randall for an Unannounced Annual/Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during the inspection was the licensee's fingerprint cleared assistant, and three (3) preschool age children. The licensee stated that the facility operates from Monday to Friday 7:00 AM to 7:00 PM. LPA toured the facility inside and outside to conduct a Health and Safety inspection. This single-story home consists of three bedrooms, two baths, a living and dining room, kitchen, backyard and attached one car garage. This home was clean and orderly, with heating and ventilation for the safety and comfort of children. The Isolation area of the home will be a section of the living room, away from other children in care. The off-limits will be made inaccessible by closed and/or locked doors and visual supervision. LPA checked the cabinets in the kitchen, bathroom, and any cabinets or drawers accessible to children in care in the on limit areas for hazards. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. On-limit-areas include: Living room, dining area, bathroom, and kitchen. Off-limit-areas include: All bedrooms, backyard, and garage. LPA tested the smoke detector(s) in the kitchen and the carbon monoxide detector in the hallway and found them to be functioning properly. The licensee showed me her first aid kit that she keeps in the garage area, and a fully charged 3A40BC fire extinguisher which meets standards established by the State Fire Marshal. This home has two wall heaters, one located in the living room and the other in the hallway that has a barricade/blocked to prevent access by children. Per licensee, there are no firearms in the home. LPA asked the licensee does she transport children and the licensee stated that she transports children everyday to school and LPA Woods took a picture of the licensee's current drivers license. See 809-C for continuance.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: RANDALL, PAMELA	FACILITY NUMBER: 013422829
	VISIT DATE: 04/22/2024

NARRATIVE

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During the record review LPA Woods checked the Health Records of the licensee, staff, and children and found that the licensee is following the immunization laws which pertain to all childcare providers. All required forms are posted and visible for public review.

The OUTDOOR PLAY area is the local park and the LPA reminded the licensee to have 100% supervision at all times when away from the facility.

At 12:45 PM LPA requested and reviewed the files of two (2) children in care. All children’s files contain Immunization, Identification & Emergency Information, Parent's Rights, and Medical Consent forms. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 11/23/23. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires 05/2024. The licensee has completed mandated reporter training on 3/6/23. The licensee is in ratio today.

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 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. The licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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-andresources/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.

See 809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: RANDALL, PAMELA	FACILITY NUMBER: 013422829
	VISIT DATE: 04/22/2024

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

The licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Pamela Randall, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There are 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, Pamela Randall.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2024

LIC809 (FAS) - (06/04)

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