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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070208971
Report Date: 01/05/2023
Date Signed: 01/05/2023 02:56:48 PM


Document Has Been Signed on 01/05/2023 02:56 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, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:COPUR, FIGENFACILITY NUMBER:
070208971
ADMINISTRATOR:COPUR, FIGENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 947-1562
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:12CENSUS: 0DATE:
01/05/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Figen CopurTIME COMPLETED:
03:15 PM
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On 1/5/2023 at 10:0am, Licensing Program Analyst (LPA) Catherine Fernandes met with Licensee Figen Copur for an Unannounced Required Annual Inspection. Present during the inspection was her fingerprint cleared assistant, and no children were in care. Residing in the home is Licensee. Licensee’s home was toured for a health and safety inspection. LPA Fernandes reviewed all licensing forms with the Licensee. The facility operates 7:30am–5:30pm, Monday-Friday.

The home is a single-story home that consists of four bedrooms and three bathrooms. The entrance to the day is on the right side of the house. The inside and outside of the home were observed to be neat, clean with age appropriate materials and toys for the children in care. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. LPA did not observe any bodies of water in or near the home. Licensee has stated that there are no firearms and no pets in the home.


ON LIMITS AREA: The right side of the home, which consists of the family room, the kitchenette , the bathroom, the bedroom and a den area and a portion of the backyard that is near the backyard door.
OFF LIMITS AREA: The three (3) Bedrooms along hallway, the two bathrooms, the main kitchen area, the living room and the rest of the backyard, which will be inaccessible by closed and/or locked doors or visual supervision.
ISOLATION AREA: will be the table in the main classroom
The home has a fully charged 3A40BC fire extinguisher located in the bathroom, a working smoke/carbon monoxide detector in the kitchenette, a working telephone and complete First Aid Kit. All required forms are posted and visible for public view in the childcare room. LPA reviewed five the children’s files, and obtained the facility roster.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:
DATE: 01/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/05/2023
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: COPUR, FIGEN
FACILITY NUMBER: 070208971
VISIT DATE: 01/05/2023
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Licensee was reminded that California Law requires Licensee to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov. Licensee was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting http://www.mandatedreporterca.com. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Children’s Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. The Licensee is reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

(NO IMS is being used at the home at this time) 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Report continues on 809C

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: COPUR, FIGEN
FACILITY NUMBER: 070208971
VISIT DATE: 01/05/2023
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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


Please submit copies of the provided forms to CCLD by 2/3/23




Notice of site visits was provided and must be posted for 30 days.
Exit interview conducted
Report and Appeal Rights provided
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6