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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407471
Report Date: 04/12/2023
Date Signed: 04/12/2023 03:50:07 PM


Document Has Been Signed on 04/12/2023 03:50 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:DEUELS DAYCAREFACILITY NUMBER:
073407471
ADMINISTRATOR:DEUEL, LEAFACILITY TYPE:
850
ADDRESS:2499 SIMAS AVETELEPHONE:
(510) 758-1355
CITY:PINOLESTATE: CAZIP CODE:
94564
CAPACITY:20CENSUS: 10DATE:
04/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:DEUEL, JONNATIME COMPLETED:
04:10 PM
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On April 12, 2023 at 1:00 PM. Licensing Program Analyst (LPA) Nyeesha Blount conducted an unannounced Annual Required Inspection and met with Assistant Director, Deuel, Jonna.
LPA disclosed the purpose of the inspection and was granted entry into the facility by the Director. There were (10) children present during this inspection and (1) additional staff members. The facility consists of two (2) classrooms. The facility was toured for a health and safety inspection. The hours of operation are 7:00 AM-6:00 PM, Monday -Friday.

CLASSROOMS: The two (2) classrooms were inspected and each room have adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair.There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is in the dining room at the kitchen table away from other children in care.The center has a smoke detector, a carbon monoxide detector, working telephone, one (4) fully charged 3A40BC fire extinguisher.

BATHROOMS AND TOILETING AREAS: The staff's bathroom is separate from the children's bathroom. All sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets. Supplies are available to the children.

FOOD SERVICE AREAS: This facility provide snacks and lunch for the children. There are monthly menus posted at the facility. All storage containers for solid waste have tight fitting covers that are in good repair.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Nyeesha BlountTELEPHONE: (510) 566-2319
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2023
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: DEUELS DAYCARE
FACILITY NUMBER: 073407471
VISIT DATE: 04/12/2023
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OUTDOOR PLAY AREAS: The playground area is fully fenced. There's play structures they are properly secured.There's a hot tub secured with latches and has no water inside. There's a canopy that provides shade to children while at play and a water table with cups to keep the children hydrated.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility.Ten (10) children's files and two (2) staff files were reviewed around 1:00PM. All children's files reviewed contained emergency information, Medical Consent forms and Personal Rights.Staff records reviewed contain required health screening. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed, and certificates were reviewed that has expired. Director's CPR and First Aid certificate was not able to locate during the inspection. The center is in compliance with the sign in and out procedure. Disaster drills are being conducted at least once every 6 months and the last one was conducted on 03/29/23. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: There's no IMS being provided at this time and no medication being stored at the facility. The center is equipped with a fully stocked first aid kit that is available in the classroom.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Nyeesha BlountTELEPHONE: (510) 566-2319
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
LIC809 (FAS) - (06/04)
Page: 6 of 6
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: DEUELS DAYCARE
FACILITY NUMBER: 073407471
VISIT DATE: 04/12/2023
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California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

LPA discussed the safe sleep regulations with facility representative 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 facility representative 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.

This facility does not provide Incidental Medical Services- IMS. For IMS information see Evaluator Manual -Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (8000 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

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Nyeesha BlountTELEPHONE: (510) 566-2319
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: DEUELS DAYCARE
FACILITY NUMBER: 073407471
VISIT DATE: 04/12/2023
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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.

Facility representative was reminded that all adults 18 and over, 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 Child Care Center. 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.

There were technical violations sited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Deuels Day Care.

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Nyeesha BlountTELEPHONE: (510) 566-2319
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6