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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423896
Report Date: 05/24/2024
Date Signed: 05/24/2024 02:23:34 PM

Document Has Been Signed on 05/24/2024 02:23 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:TITUS, ANGELAFACILITY NUMBER:
013423896
ADMINISTRATOR/
DIRECTOR:		TITUS, ANGELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 603-8187
CITY:OAKLANDSTATE: CAZIP CODE:
94612
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 5DATE:
05/24/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Angela TitusTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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On 5/24/2024 at 12:30 pm, Licensing Program Analysts (LPAs) Janai McClain and Mario Caro arrived on a case management and met with licensee Angela Titus. Present during the inspection were one fingerprint cleared assistant, two infants, three preschoolers, and one non-fingerprint cleared adult, Cian Davis.

At approximately 12:45 pm LPAs observed Cian Davis present at the facility. Cian has been employed at the daycare for approximately two months. Cian Davis does not have a fingerprint clearance, which violates Health and Safety Code of Regulation (HSC) 1596.871(c)(1)(A). This is a Type A violation and carries a civil penalty of $500.

On 05/23/2024 an incident was self reported to Community Care Licensing regarding an incident that occurred on 05/23/2024 where an unaccompanied child left the facility. Interviews indicated that there was a lack of supervision.

During the inspection LPAs reviewed facility documentation and collected the roster. Although the facility is providing supervision and are within the appropriate ratio, additional precautions must be taken to ensure children's needs are being met while in care.

LPAs informed Licensee Angela Titus that this report dated 05/24/2024 documents two Type A citations which shall be posted for 30 consecutive days as there is an immediate risk to the safety of children in care. Also, LPAs informed the licensee to provide a copy of this licensing report dated 05/24/2024 which documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

See 809C.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2024
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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Document Has Been Signed on 05/24/2024 02:23 PM - It Cannot Be Edited


Created By: Janai McClain On 05/24/2024 at 01:07 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: TITUS, ANGELA
FACILITY NUMBER: 013423896

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/25/2024
Section Cited
HSC
1596.871(c)(1)(A)

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Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance... prior to employment, residence, or initial presence in the facility. This requirement is not met as evidenced by:
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Cian Davis shall leave the daycare and the Licensee shall ensure that Cian Davis obtains a criminal clearance before being present in the childcare facility. The LPA will return to verify that Cian Davis either has a Clearance or is not present in the facility.
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Based on observation and record review, the licensee did not comply with the section cited above due to the Licensee's Assistant, Cian Davis, not having a fingerprint clearance which poses an immediate health, safety or personal rights risk to persons in care.
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Type A
05/25/2024
Section Cited
CCR102417(a)

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102417 Operation of a Family Child Care Home The licensee shall be present in the home and shall ensure that children in care are supervised at all times.

This requirement is not met as evidenced by:
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Licensee placed baby gate at day care entrance to prevent children in care from leaving the facility.
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Based on interviews, the licensee did not comply with the section cited above by ensuring no child is left without supervision. Interviews revealed C1 was left without supervision for five minutes, which poses an immediate risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mayla Mendoza
LICENSING EVALUATOR NAME:Janai McClain
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2024


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: TITUS, ANGELA
FACILITY NUMBER: 013423896
VISIT DATE: 05/24/2024
NARRATIVE
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See 809D for deficiencies cited during today's inspection.

Exit interview conducted.
Report and Appeal Rights reviewed and provided to Licensee Angela Titus.
The Notice of Site Visit must remain posted 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
LIC809 (FAS) - (06/04)
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