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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423944
Report Date: 04/18/2024
Date Signed: 04/18/2024 01:03:51 PM

Document Has Been Signed on 04/18/2024 01:03 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:KAHN, VANESSAFACILITY NUMBER:
013423944
ADMINISTRATOR/
DIRECTOR:		VANESSA KAHNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 455-9553
CITY:OAKLANDSTATE: CAZIP CODE:
94608
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
04/18/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Vanessa KahnTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 4/18/24, at 8:30am, Licensing Program Analyst (LPA) Ashley Akinleye conducted an announced prelicensing inspection. Present for the inspection was the Applicant, Vanessa Kahn. The home was toured for a health and safety inspection with the applicant. Operating hours will 8:00am- 5:30pm, Monday-Friday.

The house is a part of a two-parcel unit that includes 3 separate homes with 3 separate addresses that share an outdoor space and attached remodeled garage. This home is one of three, located at 886 43rd Street. The home is a single-story home that includes 1 bedroom, 1 bathroom, living room, kitchen, shared outdoor space and basement/garage which are neat and clean with heating and ventilation for children.

Applicant was reminded that comingling in the shared backyard is prohibited. The two other homes attached to this two-parcel property are not permitted to be of use to any children that are enrolled at this current Family Child Care Home, and no children that are enrolled in the other units are permitted to be inside this Family Child Care Home, nor shall the outdoor shared backyard be utilized at the same time.

The entrance to the day care is the front door located on the side of the home. The inside and outside of the home were observed to be neat, clean with age-appropriate materials and toys for children.
Licensee has stated that there are no firearms in the home.

Report continues on 809C
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2024
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: KAHN, VANESSA
FACILITY NUMBER: 013423944
VISIT DATE: 04/18/2024
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ON LIMIT AREAS: living room, 1 bedroom, 1 bathroom, kitchen, and shared outdoor space (including attached garage)
OFF LIMIT AREAS: Units surrounding this unit (884/880 43rd Street)
ISOLATION AREA: living room

LPA reminded applicant that share outdoor space must only be used separately from other units attached to the parcel.

The home has a working smoke detector, a carbon monoxide detector and a working telephone. LPA did not observe any bodies of water in or around the home. There is 1 pet on the property. LPA went over forms to be posted, children’s files and required facility files with applicant. Applicant states that she is aware that no other children that are enrolled in another Family Child Care Home (884/880 43rd Street) are permitted to be in this Family Child Care Home during the hours of operation.

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, 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 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.

Report continues on 809C

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
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: KAHN, VANESSA
FACILITY NUMBER: 013423944
VISIT DATE: 04/18/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information, see PIN 22-02-CCP. 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 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.

License is effective as of 4/18/24

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
LIC809 (FAS) - (06/04)
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