073406054-6-14-2019-02-CC-GRED-BD5Q8Z-20190614115735

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073406054
Report Date: 06/14/2019
Date Signed: 06/14/2019 11:57:48 AM

COMPREHENSIVE INSPECTION

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:	KLEYMAN, LANA		FACILITY NUMBER:	073406054
ADMINISTRATOR:	KLEYMAN, LANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 363-3535
CITY:	CONCORD	STATE: CA	ZIP CODE:	94518
CAPACITY:	14	CENSUS: 9	DATE:	06/14/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	KLEYMAN, LANA, LICENSEE		TIME COMPLETED:	12:15 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	Licensing Program Analyst (LPA) Redmond, arrived at the facility to conduct an Annual/Random inspection. The purpose of the inspection is to ensure Licensee is in compliance with Title 22, CCR and Health and Safety Code Statutes for a Family Day Care. During the inspection, LPA met with Lana Kleyman, Licensee. Licensee accompanied LPA during the inspection. LPA inspected all areas of the facility which are accessible to children. LPA made the following observations: Capacity/Staffing: The facility operates as a Family Day Care (small), with a capacity of 14 (fourteen) children. Currently, there are nine (9) children in care. There are no infants in care. "On Limit" Areas (accessible to children in care): · Classroom: there are age appropriate toys and equipment · Kitchen: there are no sharp items, cleaning solutions or other toxins accessible · Bedroom · Restroom (one): available for children’s use. The toilet and sinks are in good repair. There are no cleaning solutions or other toxins accessible to children · Play Yard: there are safe toys and equipment. There is a pool, which is gated. "Off Limit" Areas (not accessible to children in care): · Living room · Garage · Private bedrooms

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019

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: KLEYMAN, LANA	FACILITY NUMBER: 073406054
	VISIT DATE: 06/14/2019

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
26
27
28
29
30
31
32

REMINDERS/RESOURCES

· CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov

· Licensees may register to receive child care updates: www.myccl.ca.gov

· Resource and Referral Agencies: https://www.ccrcca.org/resources/family-resource-directory/item/california-child-care-resource-referral-network

· The childcareadvocatesprogram@dss.ca.gov is the email address for the applicant to sign up to receive PINS.

· Criminal Background Clearance: All assistants, volunteers, frequent adult visitors, adults living in the home (adults are individuals 18 years of age or older) must be fingerprint cleared and associated to the facility prior to be in the presence of children in care. Failure to comply, requires an immediate civil penalty of $100 to $3000 per person, per incident

· CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

· NEW LAW: Safe Sleep Regulations: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

· Licensees and all staff are Mandated Reporters and are required to report to CCLD suspected child abuse. Online training can be found at: www.mandatedreporterca.com.

· Licensee shall be present in the home and shall ensure children in care are supervised at all times. When temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise children in Licensee’s absence. Children shall not be left in parked vehicles.

· *LPA discussed IMS services and the requirement to update the plan of operation. Specifics on the plan can be found in the child care center evaluator manual (CCC EM) Policy 101173. 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. Americans with Disabilities Act (ADA)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.

THIS CONCLUDES FACILITY EVALUATION REPORT

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019

LIC809 (FAS) - (06/04)

Page: 3 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: KLEYMAN, LANA	FACILITY NUMBER: 073406054
	VISIT DATE: 06/14/2019

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
26
27
28
29
30
31
32

Emergency Preparedness/Safety: There is a smoke and carbon monoxide detectors. LPA tested and found to be operable. There is a fully charged fire extinguisher, with an appropriate classification of (3-A:40-B:C). First aid supplies available. Emergency Disaster Plan is 09/17/17 and is current, per Licensee. Fire and earthquake drills were last conducted on 07/19/16 and are not current. Drills must be conducted every six months. Facility utilizes a landline for phone service. Per the Licensee, there are no firearms present. The Licensee is not currently providing *Incidental Medical Services (IMS) for children in care and is aware of IMS requirements.

Training/Record Review: Licensee and adults residing in the home have criminal background clearances and are associated to the facility. Licensee and staff have current CPR/First Aid, which expire on 03/31/2020. Licensee does not provide care for infants. LPA advised Licensee of new Safe Sleep requirements and additional information is included on the last page of this report.

Posted as required: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist.

Not posted as required: If You See Something, Say Something, Pub 475 not posted. Notice given to Licensee of posting requirement. Poster can be obtained online.

Overall, the facility is clean and orderly and in good repair. There is heating and ventilation. There are safe, healthful and comfortable accommodations, furnishings and equipment. There are no other visible chemicals and toxins accessible to children.

FACILITY IN SUBSTANTIAL COMPLIANCE. NO DEFICIENCIES CITED ON THIS DATE.

Exit interview conducted. This Facility Evaluation Report discussed with the Licensee and signature obtained below. Notice of site visit was issued and shall be posted remain posted for 30 days. Failure to keep this notice posted for the 30 consecutive days will result in an immediate $100 civil penalty. A copy of this report shall be maintained for 3 years and available for public review upon request. Additional reminders and resources provided on next page. – CONTINUED ON LIC 809C

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3