070211088-1-27-2023-02-CC-CWAS-CNGQPF-20230127112040

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070211088
Report Date: 01/27/2023
Date Signed: 01/27/2023 11:20:48 AM

Document Has Been Signed on 01/27/2023 11:20 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	BALDWIN, KAREN		FACILITY NUMBER:	070211088
ADMINISTRATOR:	BALDWIN, KAREN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 625-2875
CITY:	OAKLEY	STATE: CA	ZIP CODE:	94561
CAPACITY:	14	CENSUS: 12	DATE:	01/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Laurie "Joey" Dement		TIME COMPLETED:	11:30 AM

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On 11/07/2022 at 9:00 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced 5 year required annual inspection for Karen Baldwin's large family child care home. Licensee was not home during the inspection. LPA met with aid Laurie "Joey" Dement and guided analyst on a tour of the facility. During today's inspection, there were 12 preschool children in care and 1 aid. Facility has 47 children enrolled. Family members residing in the home are licensee and licensee spouse. Licensee and all adults have criminal background clearance. Facility runs a partial in home preschool that is in session for 2 1/2 hours. Ages that are served are from 3- 5 years old. Facility hours of operations are Monday - Friday from 8:30AM - 11:00AM and 11:30AM - 2:00PM.

This is a two story home.
The children on limits areas: Play room in the back of the home that has a restroom and a kitchenette inside and the backyard.
Areas off limits include: Rest of the home and pool, garage and left side of the backyard.
The LPA toured all areas used by children during this visit.

Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and central heating system for safety and comfort. There were safe toys, play equipment and materials observed for children. There are no stairs in the home. There is a working telephone in the home. Detergents, poisons, cleaning compounds, medications, and other items which can pose a danger to children are made inaccessible in the home.

Per the aid, there are no weapons or firearms in the home. Licensee has an up to code 3A40BC fire extinguisher and working smoke/carbon monoxide detector on the premises. Licensee last conducted fire drill 12/21/2022. Aid stated there are no pets in the facility.

*CON'T ON PAGE 2*

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

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: BALDWIN, KAREN	FACILITY NUMBER: 070211088
	VISIT DATE: 01/27/2023

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*PAGE 2*

Aid stated the backyard is used for outdoor play activities. Backyard was inspected and observed to be fenced and safe. LPA observed age appropriate toys for children. The play equipment was maintained in good condition and free of hazards. LPA observed an in ground swimming pool that is fenced to state standards. Facility does not provide transportation for children, but licensee understands that children cannot be left alone, unattended in parked vehicles

Child record were reviewed to ensure that each child has an Identification and Emergency form and other required forms. All files contained required documents. The licensee Pediatric First Aid and CPR certificate is currently valid and will expire 01/08/2025. A Child's Roster was review and a copy was obtained. Required postings were observed near the entrance.

On or before March 30, 2018, any person who works in a child care facility shall complete Mandated Reporter training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. Licensee completed Mandated Reporter training and certificate will expire 03/25/2024.

LPA reminded licensee day care needs to be operated within the limitations and capacity of a Large Family Child Care Home with regards to ratios and that Licensee has to be present in the day care for 80% of the operation hours.

LPA discussed the safe sleep regulations with aid 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.

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SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

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: BALDWIN, KAREN	FACILITY NUMBER: 070211088
	VISIT DATE: 01/27/2023

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*PAGE 3*
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) Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

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

In the areas that were evaluated, there were no violation observed.

Exit interview conducted and report was reviewed with the aid, Laurie "Joey" Dement. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

LIC809 (FAS) - (06/04)

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