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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423622
Report Date: 05/24/2023
Date Signed: 05/24/2023 03:17:53 PM

Document Has Been Signed on 05/24/2023 03:17 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:DIOUF, NDEYEFACILITY NUMBER:
013423622
ADMINISTRATOR:DIOUF, NDEYEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 812-0783
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
05/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ndeye DioufTIME COMPLETED:
03:30 PM
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On 5/24/2023 at 11:22am, Licensing Program Analyst (LPA) Catherine Fernandes met with Licensee Ndeye Diouf for an Unannounced Required Annual Inspection. Present during the inspection was one fingerprint cleared helper, one infant and six preschoolers in care. Residing in the home is Licensee. Licensee’s home was toured for a health and safety inspection. The facility operates 8:00am – 5:00pm, Monday - Friday.

The home is a tri-level home that consists of four bedrooms and two bathrooms. The entrance to the day is the gate next to the front door. The inside and outside of the home were observed to be neat, clean with age-appropriate materials and toys for the children. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. During today’s inspection, LPA observed the following precautions accessible cabinets and drawers in the bathroom have safety latches and the off-limit area has a gates to prevent access. Licensee has stated that there are no firearms and no pets in the home.


ON LIMITS AREA: The two lower bedrooms that have been converted to the main areas of the day care, the lower bathroom and the backyard.
OFF LIMITS AREA: the entire 2nd and 3rd floor of the home which will be inaccessible by closed and/or locked doors or visual supervision.
ISOLATION AREA: one of the bedrooms
Report continues
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2023
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: DIOUF, NDEYE
FACILITY NUMBER: 013423622
VISIT DATE: 05/24/2023
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The home has a fully charged 2A10BC fire extinguisher located in the hallway next to the day care classrooms and a working smoke detector and carbon monoxide detector. Licensee has a working telephone, and all required forms are posted and visible for public view in the childcare room. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 5/18/2023 The Licensee's CPR and First Aid certificate is current and expires on 5/20/25. The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required training for which was conducted on 4/15/23. LPA did observe a natural body of water located behind the home which is blocked off by the enclosed backyard. LPA reviewed six the children’s files, two staff files and obtained a current facility roster, all were complete and current.

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. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov. 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. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Children’s Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. The Licensee is reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

Report continues
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023
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: DIOUF, NDEYE
FACILITY NUMBER: 013423622
VISIT DATE: 05/24/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/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-and-resources/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.
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted Report and Appeal Rights provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023
LIC809 (FAS) - (06/04)
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