013423587-6-29-2021-02-CC-PDYR-C4G2FB-20210629172115

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423587
Report Date: 06/29/2021
Date Signed: 06/29/2021 05:21:20 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:	ANDRADA, MIYANI		FACILITY NUMBER:	013423587
ADMINISTRATOR:	ANDRADA, MIYANI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 332-8806
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 5	DATE:	06/29/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:50 PM
MET WITH:	Miyani Andrada		TIME COMPLETED:	05:30 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 3:30 p.m. The licensee was present with 5 day care children (4 preschool/1 school-age) and 1 fingerprint cleared assistant. Facility is in compliance with licensed capacity/facility ratios. All staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Phone number and e-mail address are current. Hours: 7:00 a.m.-5:30 p.m. The day care area of the home was inspected. Areas licensed for child care: bathroom, living room, kitchen and one bedroom. Off-limit areas will be made inaccessible to children with closed and/or locked doors; gates; and visual supervision. The home was clean and orderly, with adequate heating and ventilation. There were safe, healthful and comfortable accommodations, furnishings and equipment available to children at the time of this inspection. There were a variety of books and toys for children's use. There was a working smoke detector (tested); a fully charged 3-A:40-B:C fire extinguisher; a first aid kit, and a carbon monoxide detector. Licensee has cots for children to nap. Bedding is laundered every 3 days by the licensee. Fireplace was blocked. There are no hazardous materials, medicines, or cleaning solutions accessible to children during this inspection. Hazardous items are kept in a high cabinet in the kitchen, inaccessible to children. Licensee stated there were no firearms or bodies of water on the premises. New Safe Sleep Regulations were discussed and given to the licensee, along with an Individual Sleeping Plan for infants. There are no infants currently enrolled at the facility. Discussed with the licensee: Individual Sleeping Plan for each infant up to 12 months of age, 15 minute checks, signs of labored breathing, skin color, increase in body temperature and restlessness; children sleeping on their backs; play yards/cribs, observing when a child awakens from a nap; placement, mattress and cribs, pacifiers, and soiled sheets. Back yard area is securely fenced. Licensee has riding toys, balls, and other outdoor toys for play (cont).

SUPERVISOR'S NAME: Phyllis Dyer	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021

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: ANDRADA, MIYANI	FACILITY NUMBER: 013423587
	VISIT DATE: 06/29/2021

NARRATIVE

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All required forms are posted and visible for public review. Last disaster drill date logged: 6/1/21. LPA reviewed facility, personnel and children's records at 4:40 p.m. Mandatory reporter training has been completed. Licensees' CPR/First Aid expires 4/24/22. A sample of files for children present today (4) were reviewed at All have emergency information in file.
Individual 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 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; swaddling; children are not to be left in parked vehicles; carseats are not to be used for sleeping; substitutes available; advertisements; changes in on-limit areas; construction work at facility; fingerprinting; paying fees on-line; smoking; if children become ill they are to be separated immediately from the other children, and the Guardian background check process. A qualified assistant must be physically present whenever 9 or more children are in care. When an assistant is not present, the home reverts back to small family child care ratios.

Important E-mail Addresses:

Mandated Reporter Training: www.mandatedreporterca.com (Child Care Providers Module - required every 2 years).
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.

Exit interview conducted. Notice of site visit must be posted for 30 days. This report must be available for public review for 3 years.

SUPERVISOR'S NAME: Phyllis Dyer	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021

LIC809 (FAS) - (06/04)

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