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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423950
Report Date: 04/24/2024
Date Signed: 04/24/2024 12:40:02 PM

Document Has Been Signed on 04/24/2024 12:40 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:MAYORAL, LEEANNA & ALFONSOFACILITY NUMBER:
013423950
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/24/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Leeanna MayoralTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On April 24, 2024 at 9:00am, Licensing Program Analyst (LPA) Janai McClain arrived at the facility for an announced Change of Location inspection. LPA met with applicant Leeanna Mayoral. Living in the home are both applicants and their four minor children. The applicants also have foster children in care, currently they have two minor foster children. The applicants have three small dogs. The applicants plans to operate Monday-Friday, 5am-8pm. LPA verified the applicant's phone number and email on record are correct.

LPA toured the home with the applicant to conduct a health and safety inspection. LPA observed that it is neat and clean with heating and ventilation for the safety and comfort of children. The house is a two story home which consists of a living room, kitchen, classroom, dining room, four bedrooms, three bathrooms, a loft, a laundry room, a shed, a fully fenced driveway, a fully fenced front yard, and a fully fenced backyard.

The Off Limit Areas are the first bedroom on the left, the entire upstairs, the laundry room, the shed, the right side of the backyard adjacent to the house, and the left side of the backyard adjacent to the house. The off limit areas are made inaccessible by gates, closed and/or locked doors and visual supervision.

The On Limit Areas are the kitchen, living room, classroom, two downstairs bathrooms, the back bedroom on the right, the fully fenced front yard, the fully fenced driveway, and the fully fenced backyard.

Isolation Area - living room

Inside the home the LPA observed an ample supply of age appropriate toys, activities and equipment for children, which appeared to be safe and in good condition. LPA did not observe any medication, bodies of water, hazardous items or poisons accessible to children during the inspection today. The applicant is reminded to monitor children when they use the plastic pool in the backyard. The pool must be emptied and turn over when it is not in use.

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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2024
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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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: MAYORAL, LEEANNA & ALFONSO
FACILITY NUMBER: 013423950
VISIT DATE: 04/24/2024
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The applicant stated there are no firearms in the home. The home is equipped with a fully charged 2A10BC fire extinguisher, working smoke detector, and a working carbon monoxide detector. Both applicants completed the preventative health and safety training with a 1 hour nutrition and lead component on 6/6/21. CPR and First Aid certificates are current and both expire on 7/15/2025. The applicants completed the Mandated Reporter training on 3/13/2023 and 3/14/2023. The applicant was reminded that the crib mattresses are to have fitted sheets made specifically for the mattress size being used for the infants.

LPA discussed the safe sleep regulations with the applicants 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.

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.



On April 24, 2024 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 address. 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.

Applicants were 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.

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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
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: MAYORAL, LEEANNA & ALFONSO
FACILITY NUMBER: 013423950
VISIT DATE: 04/24/2024
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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) 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.

The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 6 children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 8 children.

LPA 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.

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-care-licensing/subscribe and select the Child Care option to receive email communication.

A License for a small Family Child Care, with a maximum capacity of 6, is granted effective today, April 24, 2024.

Exit interview conducted. Report was reviewed and provided to applicant Leeanna Mayoral.
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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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