013423298-8-13-2020-02-CC-CFES-BSFW3L-20200813165607

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423298
Report Date: 08/13/2020
Date Signed: 08/13/2020 04:56:15 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	HART, LAWRENCE		FACILITY NUMBER:	013423298
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 2	DATE:	08/13/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	03:58 PM
MET WITH:	Lawrence Hart		TIME COMPLETED:	05:15 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 August 13, 2020 at 4:10PM Licensing Program Analyst (LPA) Catherine Fernandes conducted an announced Case Management Inspection with Licensee Lawrence Hart regarding an increase in capacity via FaceTime. Residing in the home is the licensee and his finger print cleared adult son. Present during the inspection was one infant and one school aged child as well as a finger print assistant. The home was virtually toured with the licensee to conduct a health and safety inspection. Due to COVID-19 LPA focused mainly on the physical plant of the home. The homes last annual was conducted on December 9th, 2019. Operating hours will be 6:00am to 6:00pm, Monday through Friday. The home is a two story house that consists of four bedrooms and two bathrooms. The OFF LIMIT AREAS are the entire second floor of the home, the garage, the laundry room next to the kitchen and the shed in the backyard which will be inaccessible by gate, closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the living room, the dinning room, the family room at the back of the home, which is the main area of the day care, the kitchen and the fenced in backyard. The ISOLATION AREA will be the living room near the front entrance of the home. LPA did not observe any hazardous materials or toxins accessible to children today. The home has a fully charged 2A10BC fire extinguisher and pull down fire alarm which is located in the main classroom next to the back door. In the kitchen is a working smoke detector, carbon monoxide detector in the main area of the day care, working telephone, and a First Aid Kit. The Licensee's CPR and First Aid certificate is current and expires on August 9th, 2022. Per applicant, there are no firearms in the home. The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required mandated reporter training for child care providers, which has been completed on 1/25/20. On 7/24/20, a fire clearance was granted to facility #013423298 by Oakland Fire Department. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home. REPORT CONTINUES ON 809C.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine Fernandes	TELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2020

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: HART, LAWRENCE	FACILITY NUMBER: 013423298
	VISIT DATE: 08/13/2020

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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 .

As of August 13th 2020, this home is recommended for an increase of capacity.

There are no deficiencies cited today.
The report will remain on file for three years.
An exit interview was conducted with Licensee. Report mailed and emailed.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine Fernandes	TELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2020

LIC809 (FAS) - (06/04)

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