015700165-9-26-2024-52-CC-RMIA-D9GUNF-20240926154351

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700165
Report Date: 09/26/2024
Date Signed: 09/26/2024 03:43:58 PM

Document Has Been Signed on 09/26/2024 03:43 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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	MURRAY, NIKKI		FACILITY NUMBER:	015700165
ADMINISTRATOR:	MURRAY, NIKKI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(724) 420-7863
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY:	14	CENSUS: 9	DATE:	09/26/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Nikki Murray		TIME COMPLETED:	03:45 PM

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 September 26, 2024 at approximately 12:40pm Licensing Program Analyst (LPA) Randy Miranda arrived unannounced to conduct and annual inspection for Health and Safety. Present for today’s inspection was the licensee, two (2) TB and fingerprint cleared assistants and 9 children in care (2 infants; 1 two-year old; 3 three-years old; 2 four-years olds; 1 5-year old). The facility is in ratio today. The hours of operation remain Monday-Friday, 8:00 AM to 6:00PM.

The facility is a single-story home with 3 bedrooms (one converted into childcare play room), 2 bathrooms, kitchen, dining room, living room (day care area) with a gated fire place, an attached 2-car garage, fenced front, side and backyard area.

The home is neat and clean with heating and ventilation for safety and comfort. It has wall heaters; the hallway heater is in the gated off-limits area; the heater in the living room has a movable child gate in front of the unit. There is an old pizza oven (not in use) in the back yard with a secure door on the opening. Per the licensee, the ISOLATION AREA will be in the den area and away from the other children in care.

On-limit areas include: Living room (main day care area), den (play room), dining room, house bathroom (next to the kitchen), front yard, north side yard, and back yard area. The home has age-appropriate learning materials. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area. The gardening area in the front yard was neat and tidy and had no tools or other dangerous items present, the play area in the main backyard has soft ground cover materials, safe and solid play structures and ample age-appropriate toys in good condition.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Randy Miranda	TELEPHONE: (510) 359-0974
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MURRAY, NIKKI	FACILITY NUMBER: 015700165
	VISIT DATE: 09/26/2024

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
26
27
28
29
30
31
32

Off-limit areas include: The Kitchen, master bedroom with attached bathroom, second bedroom, attached 2-car garage and fenced/locked south side of house (outside yard area). The off-limit areas will be inaccessible by closed and/or locked doors, and/or by child supervision.

LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during the inspection. Disaster drills are conducted at least once every 6 months, the last one was completed on 5/13/2024. Licensee has a first aid kit and plastic outlet covers on all electrical outlets in on-limit areas.

Per licensee there are no firearms in the home. Licensee rents the home and carries childcare liability insurance through DCI, policy expires 8/28/2025.

Licensee has ample age-appropriate toys and learning materials. The home has a fully charged 2A10BC fire extinguisher mounted on the wall of the kitchen. There is a working telephone, a smoke and carbon monoxide detector. The licensee's Health and Safety training is completed, CPR / 1^st Aid certificate is current and expires 12/02/2025. Mandated Reporter (verified AB1207), expires on 08/12/2026. Licensee is in compliance with the immunization laws which pertains to day care providers. Licensee’s assistant #2 has CPR / 1^st Aid training that expires 12/02/2025. Mandated Reporter (verified AB1207) expires 8/30/2025.

LPA reminded the licensee of the following; Mandated Reporter training is to be renewed every two years, CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility, per licensee, there are no firearms in the home.

Children’s files and Employee files were reviewed. All files were found to be complete and in good order.

Licensee 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.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Randy Miranda	TELEPHONE: (510) 359-0974
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MURRAY, NIKKI	FACILITY NUMBER: 015700165
	VISIT DATE: 09/26/2024

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
26
27
28
29
30
31
32

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-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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 Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

There were no deficiencies found during today’s inspection. This report will remain on file for 3 years.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.

Exit interview conducted and report was reviewed with the licensee Nikki Murray.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Randy Miranda	TELEPHONE: (510) 359-0974
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3