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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408689
Report Date: 11/25/2020
Date Signed: 11/25/2020 06:03:23 PM

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:MULVANEY, AMYFACILITY NUMBER:
073408689
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
11/25/2020
TYPE OF VISIT:Required - 1 YearANNOUNCEDTIME BEGAN:
01:52 PM
MET WITH:Amy MulvaneyTIME COMPLETED:
06:15 PM
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On November 25, 2020 at 1:52PM Licensing Program Analyst (LPA) Catherine Fernandes conducted an announced Annual Inspection in conjunction with an increase in capacity inspection with Licensee Amy Mulvaney. Residing in the home is the Licensee, her finger print cleared husband and her underage daughter, whom were all present during the inspection. There are no kids in care due to the holidays. Due to COVID-19 the home was virtually toured with the Licensee to conduct a health and safety inspection via Facetime. Operating hours will be 9:00am to 2:00pm, Tuesday through Friday.

The home is a single story house that consists of four bedrooms and two bathrooms. The OFF LIMIT AREAS are the all bedrooms including the bedroom that has been converted to an office, the bathroom next to the bedrooms, the entire garage, the space between the garage and house on the right side of the yard which will be inaccessible by closed and/or locked doors or visual supervision. The ON LIMIT AREAS are the living room/dining room, the playroom located next to the backyard door, the bathroom next to laundry area, the laundry area, the kitchen, the shed located in the backyard and most of the fenced in backyard. The ISOLATION AREA will be the a bed in the play room near the backyard entrance of the home. There is a fire place in the living room that is covered to prevent access by children. Per Licensee, there are no firearms in the home. There are no pools, hot tubs or any other bodies of water during today's inspection.

The main entrance to the day care is the backyard gate on the left side of the house. Upon entering the gate on the left side is a shed and a large wooden built in canopy (pergola) with tables and two outdoor sinks. There is also a tree fort that is five stairs high with a fencing around it to prevent falling and a built in large wooden swing set. Licensee has a pet dog and fenced in chickens located in the backyard.

REPORT CONTINUES ON LIC 809C.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2020
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: MULVANEY, AMY
FACILITY NUMBER: 073408689
VISIT DATE: 11/25/2020
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The home has two fully charged 2A10BC fire extinguisher one in the hallway next to the kitchen and one outside. The pull down fire alarm is on the wall next to the playroom and the backdoor. During the inspection Licensee tested the smoke detector and carbon monoxide detector both were in working condition. Licensee has a working telephone and first Aid Kit. The Licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 9/30/2020. The Licensee's CPR and First Aid certificate is current and expires on 5/9/2022.

The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required training for child care providers, which has been completed on 8/2/2020. Licensee has provided proof of the 2020 Lead Poisoning Prevention which was completed on 11/24/2020.

On 11/13/20, a fire clearance was granted to facility #073408689 by Contra Costa County Fire Department. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, 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. All forms can be downloaded at www.ccld.ca.gov .

As of 11/25/2020, this home is recommended for an increase of capacity.

There are no deficiencies cited today.
The report will remain on file for three years.
An exit interview was conducted with Licensee. Report mailed and emailed.



SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2020
LIC809 (FAS) - (06/04)
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