013423641-5-7-2021-02-CC-MDOY-C2SPFX-20210507111729

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423641
Report Date: 05/07/2021
Date Signed: 05/07/2021 11:18:06 AM

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:	RIERING-CZEKALLA, RUNA		FACILITY NUMBER:	013423641
ADMINISTRATOR:	RTIERING-CZEKALLA, RUNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 269-2449
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94602
CAPACITY:	14	CENSUS: 0	DATE:	05/07/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Runa Riering-Czekalla		TIME COMPLETED:	11:35 AM

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 May 7, 2021, Licensing Program Analyst (LPA), Melissa Domantay and LPA Melissa Guirit, met with applicant Runa Riering-Czekalla for an ANNOUNCED PRE LICENSING INSPECTION. Applicant has two small sized dogs, one cat, two bunnies, two pigs, and one guinea pig. The home was toured to conduct a Health and Safety Inspection. The facility's operating hours are 9am-4pm Monday-Friday. The home is a single story home. The home consists of one kitchen, two bedrooms, one bathroom, front living room, used for childcare, back living room used for children, and backyard. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the two bedrooms, kitchen, deck, and basement. The main entrance is off limits. Off limit areas will be inaccessible by closed and/or locked doors, baby gates, and visual supervision. The ON LIMIT AREAS are large main living area "used for childcare", one bathroom located in the hall of the home, small living room "used for childcare", and backyard. The entrance to the day care is through the left side gate. The ISOLATION AREA will be small living room that is "used for childcare". Outdoor play area will be in the backyard which is completely fenced and requires visual supervision at all times. The outdoor play area is free from defects or dangerous conditions. There is an ample supply of toys and activities available for children, and they are in good condition and age appropriate. There are no pools, hot tubs or any other bodies of water on the premises during today's inspection. Per applicant fire place is not used, however there is a secured barrier making it inaccessible to children, All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible today. See 809-C for continuos

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa Domantay	TELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2021

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: RIERING-CZEKALLA, RUNA	FACILITY NUMBER: 013423641
	VISIT DATE: 05/07/2021

NARRATIVE

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The home has a fully charged 3A40 BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone, and fully stock First Aid Kit. The applicant’s Health and Safety training is completed, lead poisoning training is completed, and CPR and First Aid certificate is current and expires 1/30/2023. Applicant completed the Mandated Reporter Training which expires on 2/23/2022. The applicant is in compliance with new immunization law which pertains to day care providers. Per applicant, there are no firearms in the home. A copy of the applicants grant deed was reviewed and shows ownership of property. A packet of forms pertaining to the children’s files and facility files were reviewed and discussed. Applicant was sent the Covid-19 self assessment, applicant has completed the assessment and emailed form to LPA Domantay

Applicant 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 .http://www.myccl.gov/

Incidental Medical Services (IMS) policy was discussed. 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

This home is recommended for licensing as of May 7, 2021. This report shall remain on file for 3 years. Exit interview conducted with applicant. A copy of this report and appeal rights will be emailed to the Applicant.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa Domantay	TELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2021

LIC809 (FAS) - (06/04)

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