013423944-1-27-2025-02-CC-CFES-DDBTF7-20250127134104

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423944
Report Date: 01/27/2025
Date Signed: 01/27/2025 01:41:21 PM

Document Has Been Signed on 01/27/2025 01:41 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	KAHN, VANESSA		FACILITY NUMBER:	013423944
ADMINISTRATOR/ DIRECTOR:	VANESSA KAHN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 455-9553
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94608
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 9	CENSUS: 8	DATE:	01/27/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:15 AM
MET WITH:	Vanessa Kahn		TIME VISIT/ INSPECTION COMPLETED:	08:50 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 1/27/2025 at 8:15am, Licensing Program Analysts (LPAs) Catherine Fernandes and Mario Caro met with Licensee Vanessa Kahn for an Unannounced Random Inspection. Present during the inspection were four infants and four preschoolers in care and three additional staff members. Residing in the home is Licensee. Licensee’s home was toured for a health and safety inspection. The facility operates 8:30am – 5:30pm, Monday - Friday. The home is a single-story house that consists of one bedroom and one bathroom. The entrance to the day care is the wooden gate between the address of 880 and 886. There are three separate licenses with three separate addresses (880, 884 and 886 43rd street) within the gated area which will be independently ran as separate day cares. LPAs reminded the licensee that no children that are enrolled in the other child care homes are permitted to be inside this Family Child Care Home, nor shall the outdoor shared backyard be utilized at the same time. The inside and outside of the home were observed to be neat, clean with age-appropriate materials and toys for the children. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. During today’s inspection, LPA observed the following precautions accessible cabinets and drawers have safety latches and the fireplace has a gates to prevent access. Licensee stated there are no firearms or pets in the home. LPAs did not bodies of water in or around home. ON LIMITS AREA: The living/ dining room, the bedroom, the kitchen, the laundry which will used as a walk through space, the detached garage located in the back of the house, and the fenced in backyard. OFF LIMITS AREA: the attached garage, the basement area, the right side of the backyard (closed off) and the other day cares located on the same vicinity (880 and 884 43rd street) which will be inaccessible by closed and/or locked doors or visual supervision. ISOLATION AREA: in the living room REPORT CONTINUES ON 809C.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

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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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: KAHN, VANESSA	FACILITY NUMBER: 013423944
	VISIT DATE: 01/27/2025

NARRATIVE

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The home has a fully charged 3A40BC fire extinguisher in the laundry room, a working smoke/carbon monoxide detector located in the dining room and the pull down alram is located near the front door. Licensee has a working telephone, and all required forms are posted and visible for public view in the childcare room. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 9/12/24 The Licensee's CPR and First Aid certificate is current and expires on 5/1/25. The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required training for all people caring for children which was conducted on 3/27/24. LPA reviewed six children’s files and all staff files and obtained a current facility roster.

Family Child Care Homes Licensee was reminded that all adults 18 and over living or working in the home, 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.

LPA discussed the safe sleep regulations with licensee 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 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.

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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

REPORT CONTINUES ON 809C.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KAHN, VANESSA	FACILITY NUMBER: 013423944
	VISIT DATE: 01/27/2025

NARRATIVE

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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

See 809D for deficiency sited during today’s inspection.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Licensee
Appeal rights, report and Notice of site visit provided.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/27/2025 01:41 PM - It Cannot Be Edited

Created By: Catherine Fernandes On 01/27/2025 at 01:12 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: KAHN, VANESSA	FACILITY NUMBER: 013423944
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/27/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/10/2025
	Plan of Correction
1 2 3 4	Licensee will send proof of immunization to CCL by POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Catherine Fernandes

LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

LIC809 (FAS) - (06/04)

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