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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408999
Report Date: 08/25/2020
Date Signed: 08/25/2020 04:19:56 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:SEDIQUE, AMYFACILITY NUMBER:
073408999
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
08/25/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
03:06 PM
MET WITH:Amy SediqueTIME COMPLETED:
04:15 PM
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On August 25, 2020 at 3:06PM, Licensing Program Analyst (LPA) Catherine Fernandes conducted an announced Case Management Inspection with Licensee Amy Sedique regarding an increase in capacity via FaceTime.
Residing in the home is the licensee, her finger print cleared husband and underage daughter. Present during the inspection was licensee, her husband, there were no children in care today. The home was virtually toured with the licensee to conduct a health and safety inspection. Due to COVID-19 LPA focused mainly on the physical plant of the home and an annual was previously conducted on January 8, 2020. Operating hours will be 6:00am to 6:00pm, Monday through Friday.
The home is a two story house that consists of five bedrooms and four bathrooms. The OFF LIMIT AREAS are the entire second floor of the home, the downstairs bedroom and the garage which will be inaccessible by gate, closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the living room which is the main area of the day care, the kitchen/dining room, the family room and the fenced in backyard. The ISOLATION AREA will be in the dinning room. LPA did not observe any hazardous materials or toxins accessible to children today.
The home has a fully charged 2A10BC fire extinguisher and two push button fire alarm systems, one is on the wall in the main day care area near the front door and the second alarm is in the hallway that connects the living room to the kitchen. There is a working smoke/carbon monoxide detector in the family room, a working telephone, and a First Aid Kit. The Licensee's CPR and First Aid certificate is current and expires on 10/2021. There is a fire place in the family room that is covered to prevent access by children. Per applicant, there are no firearms in the home.
The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required mandated reporter training for child care providers, which expires on 10/2021.

Report Continues on 809C.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2020
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 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: SEDIQUE, AMY
FACILITY NUMBER: 073408999
VISIT DATE: 08/25/2020
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A fire clearance was granted to facility #073408999 by The East Contra Costa Fire District. 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 August 25th 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: 08/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2