013423370-9-20-2022-52-CC-SCOZ-CJG5F2-20220920195425

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423370
Report Date: 09/20/2022
Date Signed: 09/20/2022 07:55:03 PM

Document Has Been Signed on 09/20/2022 07:55 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	RHODES, ERIKA		FACILITY NUMBER:	013423370
ADMINISTRATOR:	ERIKA EHODES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 771-3565
CITY:	SAN LORENZO	STATE: CA	ZIP CODE:	94580
CAPACITY:	14	CENSUS: 4	DATE:	09/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:39 PM
MET WITH:	Erika Rhodes		TIME COMPLETED:	04:40 PM

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Licensing Program Analyst Sidney Cortez, met with licensee Erika Rhodes for an UNANNOUNCED ANNUAL RANDOM INSPECTION. Present for this visit was the licensee and 5 pre school age children. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:00AM until 7PM, MONDAY-FRIDAY.

The home is a single story home, and is neat and clean with sufficient heating and ventilation. The on limit areas include the living room, dining area, first bedroom on the right side of the hallway and the bathroom. The off limit areas include the kitchen, garage and the two bedrooms on the left side of the hallway. These areas are made inaccessible by gate, closed and/or locked doors and visual supervision. The isolation area is the bedroom. The backyard is used for outdoor play and is fully fenced and free from defects or dangerous conditions. LPA observed an ample supply of toys and activities available for children, and they are age appropriate and in good condition. The home does not have a fireplace and there are no heaters accessible to children. The licensee states that there are no firearms in the home. LPA did not observe any bodies of water, toxins or hazardous items accessible to children today.

All hazardous materials and toxins are kept out of the reach of children.The home has a working smoke detector, carbon monoxide detector, working telephone, and First Aid Kit. the home has a fully charged (3A40BC) fire extinguisher. The licensee CPR and First Aid certificate is current and expires (Sept 2023). The licensee's mandated reporter training is current and expires (Aug 2023). Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on June 2022. 2 Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.
See 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sidney Cortez	TELEPHONE: (510) 295-5031
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: RHODES, ERIKA	FACILITY NUMBER: 013423370
	VISIT DATE: 09/20/2022

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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. The licensee stated that there are no children enrolled at this time, who require medication while in 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. LPA reviewed the individuals associated to the license, and the licensee confirmed that everyone who is required to have a criminal record clearance is associated.

A fire clearance, dated 7/2/19, was received for this home. LPA reviewed the ratio and capacity for a large family child care home. LPA reminded the licensee that an assistant, who is at least 14 years of age, must be present in the home and helping to care for children when operating within the ratio of a large family child care home. LPA advised the licensee that if assistant is not present, the ratio and capacity requirements for a small family child care home must be followed.

The home is recommended for a large family child care home license today. There are no deficiencies being cited today. This report will remain on file for 3 years. A notice of site visit was provided, and the licensee was reminded to have it posted for 30 days. An exit interview was conducted with the licensee.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sidney Cortez	TELEPHONE: (510) 295-5031
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

LIC809 (FAS) - (06/04)

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