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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073404516
Report Date: 05/02/2019
Date Signed: 05/02/2019 02:25:58 PM

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:COCHRAN, YOLANDAFACILITY NUMBER:
073404516
ADMINISTRATOR:COCHRAN, YOLANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 964-0625
CITY:SAN PABLOSTATE: CAZIP CODE:
94806
CAPACITY:14CENSUS: 5DATE:
05/02/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Yolanda Cochran/Monique BabbTIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced random annual site inspection for this facility at 1310. LPA met with licensee, Yolanda Cochran, and assistant, Monique Babb. LPA inspected all areas of the facility utilized by children in care for a health and safety inspection. Also present at the time of this inspection were five children in care consisting of one infant and four preschool age and assistant Austine Jackson. The on limits areas for children in care are the converted garage and attached bathroom and the back family room area. All other areas of the home are off limits to children in care and made inaccessible to children by closed doors and visual supervision. Per assistant, there are no firearms stored on the premises. There are age appropriate toys, furnishings and equipment, including infant sleeping equipment, which appear to be free of broken/sharp pieces. The facility has a working smoke detector, working carbon monoxide detector and fully charged fire extinguisher. The home has heating and ventilation available for safety and temperature management. The back patio/play area is fully fenced and the lower patio area is available to children in care with adult supervision. The upper hillside area of the back yard/outdoor space is off limits to children in care. There are no pools or other accessible bodies of water present. LPA reviewed the facility, staff and children's records including parent's rights forms, emergency ID forms and staff background clearance. LPA reviewed with licensee the current Facility Personnel Summary Report and verified that all adults requiring background clearances are cleared and associated to this facility. The facility has an up to date roster. Assistant has current CPR/First Aid which expires 07/19. For licensing forms and updates visit www.ccld.ca.gov. 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 Contact childcareadvocatesprogram@dss.ca.gov to sign up for quarterly updates.

There were no deficiencies cited during this inspection. A copy of the appeal rights was provided as well as the Safe Sleep Awareness Campaign information packet. A notice of site visit was provided and is to be posted for 30 days and a copy of this report is to be kept in the facility records for a period of three years.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
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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