073403767-8-15-2022-02-CC-CWAS-CHC3KS-20220815181933

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073403767
Report Date: 08/15/2022
Date Signed: 08/15/2022 06:19:49 PM

Document Has Been Signed on 08/15/2022 06:19 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:	SANDOVAL, LYDIA		FACILITY NUMBER:	073403767
ADMINISTRATOR:	SANDOVAL, LYDIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 565-2021
CITY:	OAKLEY	STATE: CA	ZIP CODE:	94561
CAPACITY:	14	CENSUS: 5	DATE:	08/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Lydia Sandoval		TIME COMPLETED:	05:30 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 08/15/2022 at 2:30 PM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced annual inspection at Lydia Sandoval's large family child care home. LPA met with licensee and guided analyst on a tour of the facility. During today's inspection, there were 5 children in care (4 preschool children and 1 infant) and 10 children enrolled. During inspection, 4 school age children entered the facility with an aid. Family members residing in the home are licensee, licensee daughter and licensee grandson whom are fingerprint cleared. Facility hours of operations are Monday - Friday from 6:30 AM - 6:30 PM. This is a one story home which consists of 4 bedrooms, 2 bathrooms, kitchen, dining room, living room, in law unit, detached garage, backyard with two swing set. The children on limits areas: Dining room, kitchen, bedroom(play room), hallway bathroom and backyard with two swing sets. Areas off limits include: 3 bedrooms, master bathroom, in law unit, and detached garage. The LPA toured all areas used by children during this visit. Per licensee, 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. LPA observed a screened fireplace in the living room. Licensee last conducted fire drill 02/2022. LPA reminded licensee fire drills are to be conducted every six months. Licensee stated she will perform a fire drill before the month of August ends. Currently, there is 1 dog in the facility.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

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: SANDOVAL, LYDIA	FACILITY NUMBER: 073403767
	VISIT DATE: 08/15/2022

NARRATIVE

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LPA inspected the backyard and observed anchored swing set for preschool children as well as age appropriate toys for children to play with. LPA also observed a swing set that was not anchored. Licensee states she purchase the swing set about two weeks ago. LPA informed licensee she would have to securely anchor down the infant swing set before children can play on equipment. Outdoor play area is fenced and safe for children. LPA discussed with licensee that there needs to be 100% supervision when children are playing in the backyard.

Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The licensee Pediatric First Aid and CPR certificate will expire in 03/2024. Required postings were observed near the entrance.

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.

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.

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.

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 has provided Mandated Reporter certificate and the certificate will expire 10/2023.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

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: SANDOVAL, LYDIA	FACILITY NUMBER: 073403767
	VISIT DATE: 08/15/2022

NARRATIVE

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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 were observed.

Exit interview conducted and report was reviewed with the licensee, Lydia Sandoval . 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: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

LIC809 (FAS) - (06/04)

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