070213553-1-21-2020-02-CC-PPEN-BL2QRC-20200121112342

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070213553
Report Date: 01/21/2020
Date Signed: 01/21/2020 11:23:49 AM

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:	MOORE-BANGURA, LINDA		FACILITY NUMBER:	070213553
ADMINISTRATOR:	MOORE-BANGURA, LINDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 262-9213
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94806
CAPACITY:	14	CENSUS: 5	DATE:	01/21/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Linda Moore-Bangura		TIME COMPLETED:	11:30 AM

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 0940. At arrival, LPA met assistant, Ana Ponce De Birruete, who was present with five children in care consisting of two infants and three preschoolers. Licensee, Linda Moore-Bangura, arrived at the facility while LPA was present. The facility is within ratio and capacity and all adults present are background cleared and associated to this facility. LPA toured all areas of the facility which are on limits to children for a health and safety inspection. The on limits areas are the converted garage and garage bathroom, the family room and the family room bathroom. Off limits areas are made inaccessible by child safety gating and visual supervision. There are age appropriate furnishings, toys and equipment which appear to be free of broken/sharp pieces. There are no hazardous items/toxins observed to be accessible to children in care. The facility has heating and ventilation available for safety and comfort. There are two wall heaters which are screened to prevent access by children. The fireplace is screened to prevent access. Per licensee, there are no firearms present or stored on the premises. There is a working carbon monoxide detector and working fire/smoke alarm and fully charged 3A40BC fire extinguisher. The facility has been cleared by Richmond Fire Dept. inspection within the past month. The fully fenced outdoor patio/yard is on limits to children in care with adult supervision present at all times children are using the area. There is one piece of high climbing equipment/slide/swings which is securely anchored. Licensee is reminded to check and ensure the safety of wood play equipment prior to use by children. The outdoor storage shed is securely latched. There are no pools, hot tubs or other bodies of water accessible to children in care. 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: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: MOORE-BANGURA, LINDA	FACILITY NUMBER: 070213553
	VISIT DATE: 01/21/2020

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
26
27
28
29
30
31
32

Page 2*****************************************************************************************************

LPA reviewed the personnel files for immunization records, background clearances and CPR/First Aid. Licensee and assistant both have current CPR/First Aid certification which expires 01/2022.

Children's files were reviewed for immunization records, parents rights forms, and Identification and Emergency Information forms. All required postings are present. The facility roster was brought current while LPA was present.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. 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

LPA reviewed with licensee the current Facility Personnel Report Summary and verified that all adults requiring background clearances are cleared and associated to this facility.

The Safe Sleep Awareness Campaign PIN packet was provided and reviewed. Licensee is encouraged to visit www.ccld.ca.gov for licensing regulations and forms. Licensee is reminded to renew the mandated reporter training every two years. 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 posted and is to remain posted for a period of 30 days. A copy of this report is to be maintained in the facility records for three years and available for public review.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2