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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423967
Report Date: 07/18/2024
Date Signed: 07/18/2024 04:48:00 PM

Document Has Been Signed on 07/18/2024 04:48 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:LOPEZ, LINAFACILITY NUMBER:
013423967
ADMINISTRATOR/
DIRECTOR:		LOPEZ, LINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 395-4614
CITY:BERKELEYSTATE: CAZIP CODE:
94702
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/18/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:15 PM
MET WITH:Lina LopezTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 07/18/2024, at 3:15 PM , Licensing Program Analysts (LPAs) Kareeca Sykes and Catherine Fernandes arrived announced on a prelicensing inspection for a Large Childcare Home and met with applicant Lina Lopez. Residing in the home is the applicant who is fingerprint cleared. The home was toured to conduct a health and safety inspection. The applicant plans to operate between the hours of 7:45AM -5:15PM, Monday through Friday.
The home is a single story house that is attached to a commercial building with a separate entrance. The entrance for the childcare home is through the parking lot on the left side. Applicant has confirmed that the children in the family home will not have access to the commercial space. The child care is a one bedroom and one bathroom home which is neat and clean with heating and ventilation for safety and comfort of the children. LPAs observed age appropriate toys that appear to be safe, clean and in good repair. There are no bodies of water or pools accessible to children during today’s inspection. LPA's did not observe any hazardous materials or toxins, or medications accessible during today’s inspection. Per Applicant, there are no firearms or pets in the home. During today's inspection LPA's observed the following precautions the plugs have covers to prevent access.
On-limit-areas are: The converted living/family room that is the main area of the day care, the bathroom, the wrap around yard area and the fenced in grass area.
Off-limit-areas are: The bedroom, the blocked off kitchen area, the enclosed parking lot and the commercial building that is attached by separate entrances.
The Isolation area Will be on the seating area located across from front door (reading area).
The outdoor play space will the enclosed yard next to the parking lot and the wrap around side yard.
The home has been approved for a fire clearance by Berkeley Fire Department on 6/18/2024. The home has a push button alarm and a fully charged 2A10BC fire extinguisher next to the entrance of the home. There is a working smoke detector, and a working carbon monoxide detector in the kitchen and the applicant has a working phone number. Applicant has provided a current CPR which expires 7/2025 as well as an mandated reporter certificate that was completed on 9/20/22. LPA's have received proof of control of property from the applicant. Report Continues on 809C
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Kareeca Sykes
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2024
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: LOPEZ, LINA
FACILITY NUMBER: 013423967
VISIT DATE: 07/18/2024
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This home does not plan to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

LPAs informed the applicant that all forms can be downloaded at www.ccld.ca.gov and encouraged the applicant to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The applicant was also reminded that Mandated Reporter Training is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

The applicant was provided information regarding effects of Lead Exposure.


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-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.

Applicant was reminded that all adults 18 and over living or working in the home, 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.

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SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Kareeca Sykes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024
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: LOPEZ, LINA
FACILITY NUMBER: 013423967
VISIT DATE: 07/18/2024
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On this date 7/18/2024, 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 addresses. 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.


Applicant 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.


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



In order to be licensed proof of separate addresses needs to be submitted to CCLD.


Exit interview conducted and report was reviewed with the applicant.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Kareeca Sykes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024
LIC809 (FAS) - (06/04)
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