070210589-10-18-2019-02-CC-PPEN-BH3U6V-20191018151859

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070210589
Report Date: 10/18/2019
Date Signed: 10/18/2019 03:19:12 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:	BENNER, ALAINA L.		FACILITY NUMBER:	070210589
ADMINISTRATOR:	BENNER, ALAINA L.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 232-3089
CITY:	EL CERRITO	STATE: CA	ZIP CODE:	94530
CAPACITY:	12	CENSUS: 6	DATE:	10/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Rocio Blasingame		TIME COMPLETED:	03:20 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	Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced random annual site inspection for this facility at 1:45. LPA met with assistant Rocio Blasingame and toured all areas of the facility on limits for children in care. Also present were two additional assistants, Jennifer Rangel and Corie Dziobek, and six children in care consisting of one infant and five preschoolers. The facility is within ratio and capacity. All adults present are background cleared. The on limits areas for children in care are on the lower floor of the house (the two preschool classrooms and the children's bathroom). All on limits areas were inspected for a health and safety inspection. Furnishings and equipment are age appropriate and free of observed sharp/broken pieces. There is heating and ventilation available for temperature management. Per staff, there are no firearms present or stored on the premises. There is a working smoke detector, working carbon monoxide detector and fully charged fire extinguisher. All required postings are present including license and parents' rights. The outdoor play area consists of a fully fenced deck and two additional fully fenced play areas. There are two outdoor climbing equipment/slides which are securely anchored and have cushioning under and around the equipment. The facility has two pets (rabbits). There are no pools, hot tubs or accessible bodies of water. Licensee is reminded to regularly inspect all wood outdoor play equipment for splintering/loosening and repair as needed. All required postings are present including parents' rights, facility license and emergency disaster evacuation plan. Continued on Page 2**************************************************************************************

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019

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: BENNER, ALAINA L.	FACILITY NUMBER: 070210589
	VISIT DATE: 10/18/2019

NARRATIVE

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For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. 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

LPA reviewed the facility, staff and children's records including parents' rights forms, emergency ID forms and immunization records. Assistant Rocio Blasingame has current CPR/First Aid certification. There is an up to date roster present.

LPA discussed Safe Sleep practices with assistant, and per assistant, this facility does not provide care for children under 17 months of age. Licensee is encouraged to visit www.ccld.ca.gov for licensing regulations and forms. To sign up for quarterly updates contact: childcareadvocatesprogram@dss.ca.gov.

There were no deficiencies cited during this inspection. A notice of site visit was printed and is to remain posted for thirty days. A copy of this report is to be available in the facility records for a period of three years.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019

LIC809 (FAS) - (06/04)

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