013423864-7-12-2023-02-CC-LDYN-CTNPXR-20230712114246

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423864
Report Date: 07/12/2023
Date Signed: 07/12/2023 11:42:58 AM

Document Has Been Signed on 07/12/2023 11:42 AM - 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:	LEON, ELISA		FACILITY NUMBER:	013423864
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	07/12/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:42 AM
MET WITH:	Elisa Leon		TIME COMPLETED:	11:50 AM

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 7/12/23, Licensing Program Manager (LPM) Loretta Dyson and Licensing Program Analyst (LPA) Randall Dunevant arrived at the facility for an announced prelicensing inspection. LPM and LPA met with Elisa Leon. The applicant's minor child was also present. There were no children in care. This family child care home will operate Monday-Friday 7:30am-5:30pm. LPM verified the applicant's phone number and email on record are correct. LPM and LPA toured the home with the applicant, to conduct a health and safety inspection. The home is two story home with the garage at the street level and all other areas of the home on the second level. The home consists of the living room, dining area, family room, kitchen, 3 bedrooms, 2 bathrooms and backyard. LPM and LPA observed that it is neat and clean with heating and ventilation for the safety and comfort of children. The on limit areas include the living room, kitchen, dining area, family room, two bedrooms down the hallway, the bedroom next the family room and both bathrooms. The bedroom next to the bathroom near the family room and the garage will be off limits to children and are made inaccessible by closed and/or locked doors and visual supervision. The bedroom on the right side of the hallway will be used for isolation of sick children. The lower section of the backyard will be on limits to children and the upper section of the yard will be off limits for now. The applicant will secure a gate at the bottom of the steps leading to the upper section of the yard, and will notify licensing prior to using the upper section of the yard for children. The applicant understands that this needs to be inspected by Licensing prior to use. LPM and LPA observed age appropriate activities and equipment for children, and observed that they are in good condition. LPM and LPA observed medications in the hallway closet that could be accessible to children, so the applicant was advised to secure the closet or remove the medications. LPM did not observe any bodies of water accessible to children. The applicant was advised that all poisons and/or hazardous items must be kept in a locked cabinet/drawer or placed out of reach of children. The applicant stated there are no firearms in the home. The applicant has one dog.

SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

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: LEON, ELISA	FACILITY NUMBER: 013423864
	VISIT DATE: 07/12/2023

NARRATIVE

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The home is equipped with a fully charged 3A40BC fire extinguisher, working smoke and carbon monoxide detector, working telephone, and first aid supplies. The applicant completed the preventative health and safety training which includes 1 hour of nutrition. The applicant completed the CPR and First Aid training and was issued a certificate that expires in 11/2023. The licensee has completed the mandated reporter training. LPM reviewed all of the forms required for the children's files, facility file, posting and other information related to Licensing and the care of children, and left copies with the applicant. LPM advised that applicant of where to obtain additional copies of the forms. The applicant stated that she will have documents posted outside of the front door, and LPM reminded the applicant that the required documents must be visible for the public at all times during hours of operation.

LPM reviewed children's personal rights and the applicant advised that she understands that children's personal rights should not be violated and no corporal punishment. LPM discussed supervision of children, capacity/ratio options, transportation of children, and requirements for an assistant/substitute. LPM reminded the applicant that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. LPM reviewed fire/earthquake drill information, and how to complete the drill log. LPM demonstrated how to fill out the immunization record for children's files, discussed the applicant's responsibility to ensure the records are up to date and have discussions with parents/guardians if they are not, and advised that it does not need to be done if children are enrolled in school. LPM reminded the applicant to report any injuries requiring medical attention or unusual incidents to the Oakland Regional Child Care office. LPM reviewed the form to follow up in writing within 7 days of the injury/unusual incident. The applicant was encouraged to periodically review regulations, guidelines and PINS on the website www.ccld.ca.gov.

LPM verified that the applicant, and all other adults living in the home, have a criminal record clearance and are associated to the license.

SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

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: LEON, ELISA	FACILITY NUMBER: 013423864
	VISIT DATE: 07/12/2023

NARRATIVE

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This facility will be licensed once the following items are completed:
- Gate or block access to the fire place in the living room
- Secure television in the bedroom to the right side of the hallway
- Place child safety device, or a lock, on the hallway closet door on the left side of the hallway to prevent access by children or remove the medications and cleaning product
- Secure a gate at the bottom of the steps in the backyard, to make the top section of the yard off limits to children
- Secure the storage unit in the backyard or remove the paint buckets and any other hazardous items
- Provide proof that the other individual on the home ownership document does not live in the home or obtain a criminal record clearance for that individual
- Complete the criminal record clearance transfer request for a third individual listed on the home ownership document
- secure the front load washing machine door, which is accessible to children in the family room

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

The applicant provided proof of control of property.

Because the applicant rents the home, proof of landlord notification is required. The LPM observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

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) or (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.

SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

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: LEON, ELISA	FACILITY NUMBER: 013423864
	VISIT DATE: 07/12/2023

NARRATIVE

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LPM reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPM discussed the safe sleep regulations with applicant 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. LPM also informed [applicant, licensee, or 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.

On 2/8/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, 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-carelicensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the applicant, Elisa Leon.

SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

LIC809 (FAS) - (06/04)

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