070213553-10-16-2023-02-CC-ILOA-CWNTGK-20231016144316

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070213553
Report Date: 10/16/2023
Date Signed: 10/16/2023 02:43:25 PM

Document Has Been Signed on 10/16/2023 02:43 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:	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: 3	DATE:	10/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:26 AM
MET WITH:	Linda Moore-Bangura		TIME COMPLETED:	02:53 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	On October 16, 2023 at 10:26am Licensing Program Analyst (LPA) Indira Loza met with Licensee Linda Moore-Bangura for the purpose of conducting an unannounced 1-year annual inspection. Present during today's inspection were the Licensee, a fingerprint cleared Assistant - Macesheana Smith, two infants, and two preschool age children. Operating days and times are Monday - Friday 6am-5:30pm. On Limit Areas - are the family room with half bathroom attached, converted garage with half bathroom, and the backyard. Off Limit Areas - are the entire upstairs, kitchen, dining room, two bedrooms, and living room; which will be inaccessible by closed and/or locked doors, safety gates and visual supervision. ISOLATION AREA - Depends on what activities are taking place but the child stays near the group while waiting to be picked up The home is neat and clean with heating and ventilation for safety and comfort. The home has a fully charged 3A40BC fire extinguisher and a working smoke detector next to the kitchen, and a working carbon monoxide detector in the kitchen. Per the Licensee there are no firearms in the home. The children are provided food at the daycare. LPA observed plenty of toys and activities for the children. The Licensee uses the backyard and side walkway for outdoor play and both are fully fenced. There are no pools, hot tubs or any other bodies of water on the premises during today's inspection. The Licensee has two poodles and a Labrador dog. All three dogs go in and out of the backyard and were friendly. LPA reviewed 4 children files and 2 staff files. The Licensee and her assistant had a current mandated reporter certificate expiring on February 2, 2025. The Licensee usually has Liability Insurance, but the ********************************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: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

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: MOORE-BANGURA, LINDA	FACILITY NUMBER: 070213553
	VISIT DATE: 10/16/2023

NARRATIVE

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insurance lapsed leaving the daycare uninsured. During file review it was found that the Licensee nor the Assistant had a Pediatric CPR certificate. The file reviews also indicated that infants over 12 months old did not have a sleep log.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02. When any IMS 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

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 on 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.

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 is a Plan for the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process **********************************Report Continues on LIC809-C******************************

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

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: MOORE-BANGURA, LINDA	FACILITY NUMBER: 070213553
	VISIT DATE: 10/16/2023

NARRATIVE

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During the Exit Interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There were three Type B deficiencies cited during today's visit. See LIC809-D for citations.

Exit interview conducted and report was reviewed with Licensee Linda Moore-Bangura.
Report and Appeal Rights were provided.
A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/16/2023 02:43 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: MOORE-BANGURA, LINDA	FACILITY NUMBER: 070213553
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in two out of two infants did not have sleep logs documenting the name of the child, date, and time of each check for the infants over 12 months; which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/30/2023
	Plan of Correction
1 2 3 4	The LIcensee shall maintain the sleep logs for all infants and send the LPA 5 days of sleep logs no later than October 30, 2023.

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. 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 in two out of two staff present did not have a Pediatric/Infant CPR certificate which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/15/2023
	Plan of Correction
1 2 3 4	The LIcensee shall submit a current Pediatric/Infant CPR certificate no later than November 15, 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: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/16/2023 02:43 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: MOORE-BANGURA, LINDA	FACILITY NUMBER: 070213553
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(m)(1)

(m)The licensee or registrant shall maintain one of the following: (1) Liability insurance kept in force covering injury to clients and guests in the amount of at least one hundred thousand dollars ($100,000) per occurrence and three hundred thousand dollars ($300,000) in the total annual aggregate, sustained on account of the negligence of the licensee or its employees. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as the Liability insurance was not maintained by the Licensee which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/15/2023
	Plan of Correction
1 2 3 4	The LIcensee shall either get Liability insurance coverage or have all parents sign the "Affidavit Regarding Liability Insurance for Family Child Care Homes" (LIC282); Either the proof of insurance or signed LIC282 for all parents must be sent to the LPA no later than November 15, 2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC809 (FAS) - (06/04)

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