013423788-7-10-2025-02-CC-CCON-DJG37U-20250710180030

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423788
Report Date: 07/10/2025
Date Signed: 07/10/2025 06:00:51 PM

Document Has Been Signed on 07/10/2025 06:00 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:	WHIMSY WILLOW		FACILITY NUMBER:	013423788
ADMINISTRATOR/ DIRECTOR:	DRIA MATHEWS		FACILITY TYPE:	860
ADDRESS:	1523 WILLOW STREET		TELEPHONE:	(415) 810-9057
CITY:	ALAMEDA	STATE: CA	ZIP CODE:	94501
CAPACITY: 34	TOTAL ENROLLED CHILDREN: 34	CENSUS: 0	DATE:	07/10/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:13 AM
MET WITH:	Sabrina Cazarez (Choye)		TIME VISIT/ INSPECTION COMPLETED:	06:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On Thursday, July 10, 2025 at 10:13 AM, Licensing Program Analyst, (LPAs) Caroline Colson and Applicant Sabrina Cazarez (Choye) for a new application. The applicant requests 4 Infants from 5 months to 24 months and 12 Toddler children from 18 months - 36 months and 18 preschool children from 2 years of age to 6 years of age. A health and safety inspection in all areas accessible to children was conducted. There are no children present. All components will operate on Mondays through Friday from 8:00 AM to 5:30 PM. Physical Plant: The facility has five (5) classrooms and an outdoor play area. There is adequate heating, lighting, and ventilation. There are no cleaning solutions, chemicals, or other hazards accessible to children. Per Applicant, there are no weapons at the facility. Classrooms: Furniture and equipment are age appropriate and in good repair. There are separate storage areas for children’s belongings. Drinking water will be provided and distributed in water cups from a uncontaminated water pitcher for all children. Children do take naps at the facility. There is only one crib available for the Infant Component. The remaining children will be using mats. There are mats and bedding materials for all the children. Parents will wash all bedding materials every Friday. Staff will sanitized the mats every Friday. There are four (4) first aid kits. Parent will be providing breakfast, lunch and all snacks. Please See LIC 809 for Additional Information

NAME OF LICENSING PROGRAM MANAGER: Michael Duarte
NAME OF LICENSING PROGRAM ANALYST: Caroline Colson
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: WHIMSY WILLOW	FACILITY NUMBER: 013423788
	VISIT DATE: 07/10/2025

NARRATIVE

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Restrooms: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use.

Classroom measurements:
LPA measured 2 classrooms and a corner area for the Preschool Component. The Preschool Component measurements are 521.75 square feet which will not accommodate Applicant's request for 18 Preschool children. LPA measured 2 classrooms for the Toddler Component. The total indoor measurements for the Toddler Component is 315.83 square feet and will not accommodate Applicant's request for 12 Toddler children.

There are a total of two (2) toilets, and two (2) sinks for the children. The foyer is the isolation area. The isolation bathroom is staff bathroom.

Outdoor Activity Space:
The outdoor play area is fenced by the building walls and a 4 ft tall fence. The play area has cushioning material underneath all outdoor climbing equipment. There are no bodies of water on the premises. Climbing structures and slides are safe and in good condition. Playground is free of debris and other hazards. Children have access to drinking water and will use water cups.

See LIC 809 C for Additional Information

NAME OF LICENSING PROGRAM MANAGER: Michael Duarte
NAME OF LICENSING PROGRAM ANALYST: Caroline Colson
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

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: WHIMSY WILLOW	FACILITY NUMBER: 013423788
	VISIT DATE: 07/10/2025

NARRATIVE

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Emergency Preparedness/Safety: Emergency Disaster Plan is dated and posted for review. The facility utilizes a land line telephone and cell phones. Fire Clearance was received.

Sign in/Sign out: Applicant will be using an application for sign in and sign out. Applicant will be using a sheet on a clip board as a back plan if the application doesn't work.

Licensee was reminded that all adults 18 and over, 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 Child Care Center. 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 advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.

Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure. LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Applicant 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.

Please See LIC 809 C for Additional Information

NAME OF LICENSING PROGRAM MANAGER: Michael Duarte
NAME OF LICENSING PROGRAM ANALYST: Caroline Colson
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

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: WHIMSY WILLOW	FACILITY NUMBER: 013423788
	VISIT DATE: 07/10/2025

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 ADA, available at http://www.ada.gov/childqanda.htm

LPA reviewed with Applicant the LIC 311 A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

LPA discussed 100% supervision is always required in all areas that children have access to including the bathroom. Personal Rights, inspection authority, reporting requirements, maintaining buildings and grounds was reviewed. Staff Qualifications, Staff to Children’s ratios and Capacity was explained to ensure compliance. LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Applicant 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

NAME OF LICENSING PROGRAM MANAGER: Michael Duarte
NAME OF LICENSING PROGRAM ANALYST: Caroline Colson
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

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: WHIMSY WILLOW	FACILITY NUMBER: 013423788
	VISIT DATE: 07/10/2025

NARRATIVE

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The following items are required before a license will be issued:

1. Applicant will need to ensure that she provides the department with the correct address for her facility.
2. Applicant will need to purchase tweezers for the first aid kits.
3. Applicant will need to update the Admission Agreement.
4. Applicant will need to fully established her napping area and separate from the indoor area. Infant teacher will need to visual see the child during all rests periods.
5. Applicant will need to barricade the base board heater in the Toddler classroom.
6. Job Descriptions will need to be updated.
7. Applicant will need to update all LIC 610 for each component.
8. Applicant will need to purchase trash cans for each classroom.
9. Applicant will need to update Licensing Board.
10. Applicant will need to physically separate all outdoor areas for each component and ensure shade.
11. Applicant will need to separate all inaccessible areas from the accessible areas on the playground.
12. Applicant will need to ensure all components are completely separated from other components within the facility.
13. A review of the Parent Handbook and Employee Handbook will be conducted.
14. Applicant will need to purchase 2 water pitchers and cups.
15. Fire Department will be contacted to ensure that this facility is considered a commercial/residential property.
16. Applicant will need to update the LIC 200 A.
17. Management will need to review outdoor pictures.

Once the items above have been corrected, the facility will be licensed.

NAME OF LICENSING PROGRAM MANAGER: Michael Duarte
NAME OF LICENSING PROGRAM ANALYST: Caroline Colson
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

LIC809 (FAS) - (06/04)

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