070211076-8-10-2023-02-CC-ILOA-CUL2AP-20230810171352

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070211076
Report Date: 08/10/2023
Date Signed: 08/10/2023 05:14:00 PM

Document Has Been Signed on 08/10/2023 05:14 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:	KEEL, MESHELLE		FACILITY NUMBER:	070211076
ADMINISTRATOR:	KEEL, MESHELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 232-8458
CITY:	SAN PABLO	STATE: CA	ZIP CODE:	94806
CAPACITY:	12	CENSUS: 0	DATE:	08/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:56 PM
MET WITH:	Meshelle Keel		TIME COMPLETED:	05:21 PM

NARRATIVE

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On August 10, 2023 at 3:56pm Licensing Program Analyst (LPA) Indira Loza met with Licensee Meshelle Keel for the purpose of conducting an unannounced 1-year annual inspection. Present for today’s inspection were the Licensee, her fingerprint cleared cousin, and underage nephew. There were no children in care during today's inspection. Hours of operation are Monday - Friday 6:30am-5pm.

The facility is a single story home consisting of four bedrooms, two bathrooms, living room, family room, kitchen, small dining area, fully fenced in front yard and fully fenced in backyard.

ON LIMIT AREAS: Bathroom across from the small dining area, family room, and bedroom next to the family room (nap and isolation room), and a portion of the backyard,

OFF LIMIT AREAS: The living room, three bedrooms and one bathroom on the left side of the house, kitchen, a portion of the backyard, and the front yard

ISOLATION AREA is in the bedroom next to the family room

The home has heating and ventilation for safety and comfort. The home has a fully charged 3A40BC fire extinguisher in the kitchen. There is a working smoke detector, carbon monoxide detector, and a working telephone. Licensee has ample age-appropriate toys and learning materials inside and outside the home. Toxins, medicines, and hazardous items were inaccessible during today's inspection. The Licensee utilizes her backyard for outdoor play. LPA reviewed children's and the Licensee's file which were found to be complete. The facility roster was reviewed, and a copy obtained. The Licensee had a current Mandated Reporter certificate which expires March 24, 2024 and CPR expires January 2024.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02. 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 **********************************Report Continues on LIC 809-C*******************************

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023

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: KEEL, MESHELLE	FACILITY NUMBER: 070211076
	VISIT DATE: 08/10/2023

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-Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
- Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
- Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
- 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.
- 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/inspection-process.
- Licensee was provided with the Infant Safe Sleep Regulations
- During the exit interview, the Licensee Meshelle Keel, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There was a Type B deficiency issued during today's visit.

See LIC 809-D for the Type B citation.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Meshelle Keel.

Report and Appeal Rights were provided.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/10/2023 05:14 PM - It Cannot Be Edited

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: KEEL, MESHELLE	FACILITY NUMBER: 070211076
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(9)(A)1

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as the fire drills were not being recorded on the fire drill log which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/01/2023
	Plan of Correction
1 2 3 4	The Licensee shall conduct a fire and earthquake drill and document the drills on the log, and email a copy of the log to LPA Loza no later than September 1, 2023.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023

LIC809 (FAS) - (06/04)

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