015700165-8-18-2021-52-CC-RHAR-C5ZNNR-20210818103711

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700165
Report Date: 08/18/2021
Date Signed: 08/18/2021 10:37:20 AM

Document Has Been Signed on 08/18/2021 10:37 AM - 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:	MURRAY, NIKKI		FACILITY NUMBER:	015700165
ADMINISTRATOR:	MURRAY, NIKKI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(724) 420-7863
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 2	DATE:	08/18/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Nikki Murray		TIME COMPLETED:	10:40 AM

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On August 18, 2021 at approximately 8:50am Licensing Program Analyst (LPA) Haderer arrived for the purpose of conducting an unannounced 1-year annual inspection for Health and Safety compliance. Present for today’s inspection was the licensee, her TB and her fingerprint cleared (new) assistant Kyle Keane. There were 2 children in care (one 3-year old and one 4 year old). The hours of operation will be Monday-Friday, 8:00 AM to 6:00PM.

The facility is a single story home with 3 bedrooms (one converted into childcare play room), 2 bathrooms, kitchen, dining room, living room with a fireplace (not in use) with a gate in the opening, an attached 2-car garage, fenced front, side and backyard area. Licensee rents the home, rental agreement and signed landlord consent agreement has been submitted to licensing.

The home is neat and clean with heating and ventilation for safety and comfort. It has wall heaters; the hallway heater is in the gated off-limits area; the heater in the living room has a movable child gate that will be placed in front of the unit whenever it is operating and children are present. Per the licensee, the ISOLATION AREA will be in the child playroom area and away from the other children in care.

On-limit areas include: Living room (main day care area), converted bedroom/den (dramatic play room), dining room, house bathroom (next to the kitchen), front yard, north side yard, and back yard area. The home has age-appropriate learning materials. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area. The gardening area in the front yard was neat and tidy and had no tools or other dangerous items present, the play area in the main backyard has soft ground cover materials, safe and solid play structures and ample age-appropriate toys in good condition. There is a old stone oven (not in use) and a new elevated play structure under construction, off limits until it is completed and approved by licensing.

Chandra Charles
Russell Haderer
	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: MURRAY, NIKKI	FACILITY NUMBER: 015700165
	VISIT DATE: 08/18/2021

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Off-limit areas include: The Kitchen, master bedroom with attached bathroom, second bedroom, attached 2-car garage and fenced/locked west side of house (outside yard area). The off-limit areas will be inaccessible by closed and/or locked doors, and/or by child supervision.

LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during the inspection. Disaster drills are conducted every 6 months, the last one was completed on 7/6/2021. Licensee has a first aid kit and plastic outlet covers on all electrical outlets in on-limit areas.

Licensee has ample age-appropriate toys and learning materials. The home has a fully charged 2A10BC fire extinguisher stored in kitchen. There is a working telephone, a smoke detector and carbon monoxide detectors (tested and functioning). The licensee’s Health and Safety training is completed, and CPR and First Aid certificate is current and expires 12/07/2021. Licensee's certificate in mandated reporter training (verified AB1207), expires on 08/09/2022. Licensee is in compliance with the immunization laws which pertains to day care providers. Licensee’s new assistant Kyle Keane has CPR / 1^st Aid training that expires 12/7/2021. Mandated Reporter training will be completed by 8/23/2021.

LPA reminded the licensee of the following; Mandated Reporter training is to be renewed every two years, CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility, per licensee, there are no firearms in the home. At 9:45am facility and children’s files were reviewed and all found to be in compliance.

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

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information 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

SUPERVISOR'S NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

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: MURRAY, NIKKI	FACILITY NUMBER: 015700165
	VISIT DATE: 08/18/2021

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The applicant is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing.

LPA reviewed guidance on operating safely during the Covid pandemic, including all adults and children over the age over age two must wear face coverings while indoors. Posters were present and the checking in process of children was observed.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and advised to be added to the email list

There were no deficiencies cited today, the facility report will remain on file for three 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 licensee

SUPERVISOR'S NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021

LIC809 (FAS) - (06/04)

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