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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405751
Report Date: 06/05/2023
Date Signed: 06/05/2023 12:05:12 PM


Document Has Been Signed on 06/05/2023 12:05 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:ICANBERRY, BETTYFACILITY NUMBER:
073405751
ADMINISTRATOR:ICANBERRY, BETTYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 820-7535
CITY:ALAMOSTATE: CAZIP CODE:
94507
CAPACITY:14CENSUS: 4DATE:
06/05/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Betty Icanberry- LicenseeTIME COMPLETED:
12:15 PM
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On 6/5/23, Licensing Program Analyst Briana Plumboy, met with licensee Betty Icanberry for an UNANNOUNCED ANNUAL INSPECTION. Present for this visit was licensee's fingerprint clear and associated husband Mark Icanberry, and 4 children in care (2 infants and 2 preschool age children).The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:00am until 5:30pm.

The home appears to be neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are area consist of the living room, kitchen, four bedrooms, bathroom located near the kitchen area, and fenced yard. The remainder of the home is off limits, which is made inaccessible by use of closed and/or locked doors and visual supervision. There are toys and learning materials. There are no pools, hot tubs or any other bodies of water present in the on limits areas during today's inspection. All hazardous materials and toxins are kept out of the reach of children and it was observed that during the inspection there are no toxins or hazardous items accessible to children in care during today's inspection.

The home has a fully charged fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The licensee's CPR and First Aid certificate is current and expires 1/28/25. The licensee's mandated reporter training is complete and she received a certification of completion on 12/16/21. The licensee is in compliance with the immunization law which pertains to childcare providers. The fireplace is screened to prevent access by children. Per licensee, there are firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 1/3/23. 4 Children files were reviewed and facility roster reviewed. The licensee is in ratio today. The licensee documents sleep checks for infants and presented her log to LPA Plumboy as well as utilizes Lic. 9227. All REQUIRED forms are posted and visible for public review. See 809-C for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: 510-286-4356
LICENSING EVALUATOR SIGNATURE:
DATE: 06/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/05/2023
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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ICANBERRY, BETTY
FACILITY NUMBER: 073405751
VISIT DATE: 06/05/2023
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Incidental Medical Services (IMS) policy was discussed. 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) 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 encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensee Betty Icanberry 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 Betty Icanberry 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.

A notice of site visit was given and must remain posted for 30 days.

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Betty Icanberry.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: 510-286-4356
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023
LIC809 (FAS) - (06/04)
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