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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408585
Report Date: 08/18/2022
Date Signed: 08/18/2022 12:23:44 PM


Document Has Been Signed on 08/18/2022 12:23 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:KATO, AKIKOFACILITY NUMBER:
073408585
ADMINISTRATOR:KATO, AKIKOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 359-8951
CITY:EL CERRITOSTATE: CAZIP CODE:
94530
CAPACITY:14CENSUS: 8DATE:
08/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:KATO, AKIKOTIME COMPLETED:
12:45 PM
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On August 18, 2022 at 10:00 AM, Licensing Program Analyst (LPA) Nyeesha Blount met with Licensee Kato, Akiko, and assistant's Akiko, Kohnen, and Neptune, Kai Lisa who is background cleared for an unannounced random annual inspection. There are (8) preschool children present during the time of the inspection. the facility operating hours are Monday -Friday 8:30 AM to 5:00 PM. LPA toured all on limits areas of the facility for health and safety inspection. all required postings are posted in the entry way of the day care on the wall..

The home is a two story level consists of an living room, dining room, kitchen, (3) bedrooms, (2) bathrooms, fenced backyard, and garage. the lower level of the home is the Main day care area. the day care is neat and clean and has central heating and ventilation for safety and comfort. There is sufficient amount of age appropriate furnishings, toys, books and learning materials available. Licensee states that there are no weapons in the home. All hazardous materials and toxins are stored away inaccessible to children in care at the time of the inspection .The day care is equipped with a fully charged 2A10BC fire extinguisher, working smoke detector and working carbon monoxide detector. Pediatric CPR and First Aid are current and will expire on March 20, 2023

ON LIMIT areas of the day care will be the classroom, kitchen, bathroom, playroom.

OFF LIMIT areas are the entire upper level of home, day care Office, (2) Stock rooms, Laundry room.

Outdoor Space: The fenced back yard is the outdoor play space. The entire area was inspected to ensure the health and safety of the area. all play structures are properly secured. There are no pools, hot tubs or any other bodies of water on the premises during today's inspection.

Isolation Area : will be the playroom to the right at the end of the hallway.

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Nyeesha BlountTELEPHONE: (510) 566-2319
LICENSING EVALUATOR SIGNATURE:
DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/18/2022
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 2


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: KATO, AKIKO
FACILITY NUMBER: 073408585
VISIT DATE: 08/18/2022
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LPA reviewed the facility staff and children's records including parents' rights forms, emergency ID forms and consent for emergency medical treatment forms. Licensee CPR/First Aid, Mandated Reporter Certificate for Licensee is all up to date.

LPA discussed the safe sleep regulations with licensee 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 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. there are no firearms stored or present in the home.

Per incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Licensee was reminded about importance to stay in compliance with mandated reporter training and maintenance of sleep logs for all infants in care. In the areas that were evaluated, no regulatory violations were observed.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Exit interview conducted and report was reviewed with the licensee KATO, AKIKO
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Nyeesha BlountTELEPHONE: (510) 566-2319
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2022
LIC809 (FAS) - (06/04)
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