<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408755
Report Date: 05/08/2020
Date Signed: 05/08/2020 04:28:13 PM

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:ROBINSON, SHANEECEFACILITY NUMBER:
073408755
ADMINISTRATOR:ROBINSON, SHANEECEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 228-6809
CITY:BAY POINTSTATE: CAZIP CODE:
94565
CAPACITY:14CENSUS: 3DATE:
05/08/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Shaneece RobinsonTIME COMPLETED:
04:30 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
On 5/8/2020 Licensing Program Analyst (LPA) Jaylena Miller met with licensee Shaneece Robinson for an announced CASE MANAGEMENT inspection and INCREASE OF CAPACITY to a large family childcare home during the COVID-19 Shelter in Place. Due to the COVID-19 and inability to conduct and on site inspection the inspection was via FACETIME. Present for the inspection were two school age children and the licensees daughter as well as her assistant. LPA toured the facility and backyard for a health and safety inspection. The home has an acceptable amount of space, number of toys and furnishings that are neat, clean and age appropriate. The home is equipped with a 3A-40BC fire extinguisher, working smoke detector, and working carbon monoxide detector. There is a working telephone in the home. Per licensee there are no firearms on the premises. There is a hot tub in the back yard that is locked and can withstand the weight of an adult. All poisons, cleaning solutions and medications are inaccessible to children. Licensee has current CPR/First Aid training which expires 10/2020, Mandatory reporter training was conducted on 10/5/2020. LPA Miller reminded licensee that CPR/First Aid and Mandatory Reporter training must be renewed every two years.

Due to the shelter in place Licensee was unable to obtain a fire clearance, however under the blanket waiver PIN 20-04-CCP the licensee is able to temporarily act as a large family childcare home during the shelter in place. LPA Miller advised licensee to print PIN 20-04-CCP and follow the guidelines of the PIN as well as PIN 20-06-CCP.

This home is recommended for a provisional large family home license as of 05/8/2020 and will expire on 6/30/2020. If the current shelter in place is still in effect the provisional license can be extended. This report shall remain on file for 3 years.

Exit interview conducted with Licensee and a copy of report provided via email. LPA Miller let licensee know that the report must be printed and signed and returned to the main Oakland office as soon as possible.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Jaylena MillerTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2020
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 1