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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419701
Report Date: 01/09/2024
Date Signed: 01/09/2024 02:18:20 PM

Document Has Been Signed on 01/09/2024 02:18 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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:YOUNG, FLORAFACILITY NUMBER:
013419701
ADMINISTRATOR:YOUNG, FLORAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 656-5977
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 9DATE:
01/09/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Flora YoungTIME COMPLETED:
02:30 PM
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On 01/09/2024 12:15PM Licensing Program Analyst (LPA) Jaleesa Jackson arrived at for an Unannounced Required Inspection, and met with Licensee Flora Young. Present for this inspection was 9 preschool aged children. Also present for the inspection was the Licensees fingerprint cleared husband and assistant. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8:00AM - 5:30PM.

ON LIMITS: Family room, Bonus room (across from the family room), Bathroom #1 (in bonus room), backyard, dining area, living room (isolation area), and front yard
OFF LIMITS: Garage, Kitchen, both sides of the backyard, outdoor shed, Bathroom #2 and #3, and all Bedrooms. Off limit areas are inaccessible by closed and/or locked doors, gates, and visual supervision.

The home is single story, which is neat and clean, with heating and ventilation for safety and comfort. LPA observed there were age appropriate toys that are in safe and good condition. During today's inspection all toxins, medicines, and hazardous items were inaccessible. A fully charged 2A10BC fire extinguisher located in the kitchen area. The home has a fully functioning smoke detectors and carbon monoxide detector. The home has a wall heater and fireplace that are blocked off. There is also a telephone present at the facility. Licensee stated that there are no firearms or pets or smoking at the facility.

LPA toured the front and back yard area and both areas are fully fenced. Children play outdoors in both the front and backyards. There are no swimming pool, hot tubs, or bodies of water present at the facility. Side yards and outdoor shed are closed and off limits to children.

Continued on 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2024
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YOUNG, FLORA
FACILITY NUMBER: 013419701
VISIT DATE: 01/09/2024
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At 12:45PM, all 9 children's files were reviewed and found to be complete. The facility roster was reviewed, and a copy obtained. The licensee is in ratio today. The Licensee, assistant, and Licensees husband all have current Mandated Reporter Training and CPR and First aid. Licensee also has liability insurance from the Markel Insurance Company that is valid for 09/01/2023 to 09/01/2024. The licensee conducts and documents disaster drills at least every 6 months. The last fire drill was 11/27/2023. The last earthquake drill was 9/22/2023. All required licensing documents are posted and visible for public review.

There were no deficiencies cited on today's visit. Appeal rights were given to Licensee.

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.

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.

LPA discussed the safe sleep regulations with licensee 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 licensee 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.

Continued on 809-C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024
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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YOUNG, FLORA
FACILITY NUMBER: 013419701
VISIT DATE: 01/09/2024
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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 childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Flora Young, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted and report was reviewed with the licensee Flora Young.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024
LIC809 (FAS) - (06/04)
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