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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010215117
Report Date: 06/22/2023
Date Signed: 06/22/2023 05:07:43 PM

Document Has Been Signed on 06/22/2023 05:07 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:JOSEPH-WHITEHEAD, DELORIS JFACILITY NUMBER:
010215117
ADMINISTRATOR:WHITEHEAD-JOSEPH, DELORISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 482-9635
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 6DATE:
06/22/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
01:59 PM
MET WITH:Deloris Joseph-WhiteheadTIME COMPLETED:
05:16 PM
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On June 22, 2023 at 1:59pm Licensing Program Analyst (LPA) Indira Loza arrived at the facility to conduct an annual continuation inspection. Present for the inspection were the Licensee, Licensee's assistants (Husband and Daughter), two infants, two preschool age children, and two school age children. The home was inspected for a Health and Safety check. Operating hours are Monday through Friday 6:00am to 6:00pm.

The home is one story apartment consisting of a living room, kitchen, three bedrooms, two bathrooms, ans a fully eclosed backyard The child care areas are the living room and backyard. The off limit areas are all three bedrooms, the bathroom connected to the master bedroom, kitchen and dining room (only used to walk through to the childcare areas). The on limit areas are the kitchen, bathroom, and backyard. The Isolation area is on the couch in the living room.

The Licensee’s Pediatric CPR and First Aid training has been completed and expires March 2024. LPA obtained the children’s files for review and the children's roster. Last Fire Drill was conducted April 25, 2023. The Licensee provides breakfast, lunch, and two snacks. The home was observed to be neat and clean with ample age appropriate toys. LPA observed the home to have heat and ventilation for the comfort of children. Per Licensee there are no firearms in the home. The Licensee has Liability Insurance. The Licensee has a current mandated reporter certificate which expires on April 24, 2025.

Licensee was reminded that California Law requires Licensee 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 email. Licensee was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting http://www.mandatedreporterca.com.

*************************Report Continues on LIC809-C*********************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2023
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: JOSEPH-WHITEHEAD, DELORIS J
FACILITY NUMBER: 010215117
VISIT DATE: 06/22/2023
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

During the exit interview, Licensee Joseph-Whitehead, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Exit interview conducted and report was reviewed with the licensee Deloris Josepth-Whitehead.
Notice of Site visit and appeal rights were provided.
Notice of Site Visit must remain posted for 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023
LIC809 (FAS) - (06/04)
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