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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418060
Report Date: 03/14/2024
Date Signed: 03/14/2024 03:43:43 PM


Document Has Been Signed on 03/14/2024 03:43 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:FERREIRA, ROXANAFACILITY NUMBER:
013418060
ADMINISTRATOR:FERREIRA, ROXANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 499-1042
CITY:ALBANYSTATE: CAZIP CODE:
94706
CAPACITY:14CENSUS: 8DATE:
03/14/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Yureny SarabiaRamirezTIME COMPLETED:
04:00 PM
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On 3/14/2024, at 12:15PM Licensing Program Analyst (LPA) Brittany Crass arrived at the home for an unannounced required/random inspection. The licensee, Roxana Ferreira was not present. LPA met with assistant Yureny SarabiaRamirez. There were 8 preschool aged children in care during the inspection. Also present during the inspection were two other fingerprint cleared assistants, and one medical professional behavior specialist employed by the parents of one of the children in care who has autism. The licensees fingerprint cleared daughter arrived at 1:15PM. This family childcare home operates Monday - Friday 8AM-5PM. LPA verified that the licensee's phone number and email address on file are correct.

LPA toured the on-limits areas of the home with assistant, Yureny Sarabiaramirez to conduct a health and safety inspection. The home is a single story home, with an attic space which is the licensees room. LPA observed that the home is neat and clean with heating and ventilation for the safety and comfort of children in care. The on-limit areas include the first bedroom to the right of the front door, the bathroom, the back bedroom, the living room, the kitchen, and a fully fenced in backyard. The off-limit areas are made inaccessible by closed and/or locked doors, gates, and visual supervision. The fully fenced in front porch is used for isolation of sick children, away from other children in care. The fireplace in the living room is blocked to prevent access by children. LPA observed an ample supply of age-appropriate toys, equipment and activities available for children both indoors and outdoors and observed that they are in good condition. LPA did not observe any bodies of water, toxins, medications or hazardous items that would be accessible to children. The assistant stated that there are no firearms on the premises.

The home is equipped with fully charged 3A40BC fire extinguisher, a working carbon monoxide detector, working smoke detector, and a working telephone. Licensee has proof of current CPR/First aid certificates, which expire on 8/25/2025, and all assistants also had current CPR certificates. The last documented earthquake drill was conducted on 2/28/24. LPA observed all of the required forms posted. LPA reviewed children's files, staff files and obtained a copy of the current roster.

(Report continued, See 809-C).

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany CrassTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024
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 5


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: FERREIRA, ROXANA
FACILITY NUMBER: 013418060
VISIT DATE: 03/14/2024
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The facility representative 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.

LPA discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed the facility representative 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.

LPA reminded the assistant that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. LPA provided the main office number for the Oakland Regional Child Care office (510) 622-2602 for the licensees to call and report injuries or unusual incidents and reviewed the form to follow up in writing within 7 days of the injury/unusual incident. The licensees were encouraged to periodically review regulations, guidelines and Provider Information Notices (PINs) on the website www.ccld.ca.gov.

NO CHILD NEEDS IMS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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/.

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

(Report continued, See 809-C)

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany CrassTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: FERREIRA, ROXANA
FACILITY NUMBER: 013418060
VISIT DATE: 03/14/2024
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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, the assistant Yureny Sarabiaramirez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA reminded the assistant that the mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

There were no deficiencies cited during todays visit.

A notice of site visit was given and must remain posted for 30 days.

Appeal rights provided and discussed.

Exit interview conducted and report was reviewed with the assistant Yureny Sarabia Ramirez.

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany CrassTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC809 (FAS) - (06/04)
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