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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073404516
Report Date: 03/03/2020
Date Signed: 03/03/2020 01:24:50 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: 3DATE:
03/03/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Monique Babb/Yolanda CochranTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced random annual site inspection for this facility at 1140. At arrival, LPA met assistant Monique Babb who was present along with three preschool age children in care. The facility is within ratio and capacity. Licensee Yolanda Cochran was also present in the residence during this inspection. All adults present were background cleared and associated to this facility.

The on limits areas were toured for a health and safety inspection. The on limits areas are; the converted garage, the children's bathroom, and the back family room. Off limits areas are made inaccessible by closed doors and adult supervision. There were no hazardous items/toxins observed to be accessible to children in care. The facility has a working carbon monoxide detector, and fully charged 3A40BC fire extinguisher. Per assistant, the most recent fire dept. inspection was approximately April 2019. There is one fireplace in the off limits area which is screened. Per licensee, there are no firearms present or stored on the premises. There is age appropriate furnishings, play items and equipment (including infant sleeping equipment) which are free of broken/sharp pieces. There is one pet (dog).

The back patio area is fully fenced and on limits to children in care. The separately fenced yard area is off limits to children in care. The hillside areas surrounding the patio are off limits to children in care. There are no pieces of high climbing equipment of swings present. There are no pools, hot tubs or other bodies of water accessible to children in care.

All required postings are present. Children's files were reviewed for parent's rights forms, identification and emergency information forms and immunization records.

Continued on Page 2*************************************************************************************
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020
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 3
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: COCHRAN, YOLANDA
FACILITY NUMBER: 073404516
VISIT DATE: 03/03/2020
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Staff and facility records were reviewed for background clearances, and CPR/First Aid. At approximately 12:35 LPA observed that neither assistant or licensee have current CPR/First Aid certification present during this inspection which was verified by licensee. At approximately 12:40 LPA verified with facility assistant that the disaster drill log does not have record of any disaster drills since 05/2019.

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

Licensee is encouraged to visit www.ccld.ca.gov for licensing regulations and forms. To sign up for quarterly updates contact: childcareadvocatesprogram@dss.ca.gov. Licensee is reminded that the Mandatory Reporter Training is due to be completed for all child care staff every two years. The Safe Sleep Regulations for infants was reviewed and provided to licensee.

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

The attached Type B deficiencies were cited during this inspection. A copy of the appeal rights was provided and 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 available in the facility records for three years from today's date.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: COCHRAN, YOLANDA
FACILITY NUMBER: 073404516
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/02/2020
Section Cited

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102416(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.
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This facility was not in compliance with this requirement as evidenced by LPA's observation, verified by licensee, that neither the assistant or licensee had current CPR/First Aid certification present at the time of this inspection posing a potential risk to children in care.
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Type B
03/18/2020
Section Cited

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102417(g)(9)(A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. This facility was not in compliance with this requirement as evidenced by LPAs' observation that there has not been a disaster drill documented within the past six months posing a potential risk to the health and safety of children.

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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: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3