013423926-5-17-2024-02-CC-JMCN-D5CVN6-20240517163438

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423926
Report Date: 05/17/2024
Date Signed: 05/17/2024 04:34:43 PM

Document Has Been Signed on 05/17/2024 04:34 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:	EMBREY, TIARA		FACILITY NUMBER:	013423926
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 6	TOTAL ENROLLED CHILDREN: 6	CENSUS: 4	DATE:	05/17/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	04:00 PM
MET WITH:	Tiara Embrey		TIME VISIT/ INSPECTION COMPLETED:	04:35 PM

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On May 17, 2024 at 4:00 pm Licensing Program Analyst (LPA) Janai McClain met with Licensee Tiara Embrey to conduct a case management inspection for a Capacity Increase. Present during today's visit were the Licensee, her fingerprint cleared assistant, and four preschool age children in care. The operating hours are 6am-5pm Monday-Friday.

The single story home consists of a living room, kitchen, dining area, two bedrooms, one bathroom, and a fully fenced backyard.

The Off Limit Areas are the kitchen, living room, and both bedrooms. The off limits areas will be made inaccessible by gate, closed and/or locked doors and visual supervision.

The On Limit Areas are the bathroom, dining room, and fully fenced backyard.

LPA did a walk through of the home and observed a working smoke detector and working carbon monoxide detector. There is a 2A10BC fire extinguisher in the kitchen. The Licensee does not have Liability Insurance.

On 05/10/24, a fire clearance was granted to facility #013423926 by Oakland Fire Department. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

As of 5/17/24 the home has been approved to operate as a large family day care license.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families
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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2024

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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: EMBREY, TIARA	FACILITY NUMBER: 013423926
	VISIT DATE: 05/17/2024

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obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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

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.

LPA 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. 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.

A License for a Large Family Day Care with a Capacity of 12 children will be granted effective today, May 17, 2024.

Exit interview conducted.
Report reviewed with Licensee. Report and Appeal Rights provided to Licensee.
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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2024

LIC809 (FAS) - (06/04)

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