015700261-8-2-2023-52-CC-RHAR-CUBPKA-20230802112248

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700261
Report Date: 08/02/2023
Date Signed: 08/02/2023 11:22:55 AM

Document Has Been Signed on 08/02/2023 11:22 AM - 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	LANDES, SHAYNA		FACILITY NUMBER:	015700261
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 0	DATE:	08/02/2023
TYPE OF VISIT:	Required - 1 Year	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Shayna Landes		TIME COMPLETED:	11:25 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 August 2, 2023 at approximately 8:30am, Licensing Program Analyst (LPA) Russ Haderer arrived announced for a combined case management capacity change and annual inspection and met with licensee Shayna Landes. The child care is currently closed for a break (until August 24, 2022); therefore there were no children in care today. Currently there are 6 children enrolled (3 three years old; 3 four years old). Present for the inspection was the licensee. The hours of operation will be Monday-Thursday, 8:00am to 6:00pm, Friday closes at 2pm. Fire clearance was granted by the Fremont Fire Department on July 25, 2023; the only restriction being the garage is considered off-limits to children in care. A pulldown fire alarm has been added and mounted on the wall near the southern sliding exit door from the family room. The home has a fully charged 2A10BC fire extinguisher mounted on the kitchen wall, combined smoke and carbon monoxide and a single carbon monoxide detector (tested and functioning), and a working telephone. Fire drills are conducted at least once every six months, the last drill was done May 8, 2023. The facility is a rented single story 5-bedroom, 3 bath home with a living room, family room with a fireplace, kitchen, bonus room (office), an enclosed (fenced) side and backyard area and an attached 2-car garage. The home is neat and clean with heating and ventilation for safety and comfort. Per the licensee, the ISOLATION AREA will be in the office area that’s attached to the family room, and away from the other children in care. There are ample age-appropriate toys and learning materials and children have cubbies for personal items. There is a fireplace in the family room (day care area) with a glass door to prevent child access. LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during the inspection. Per licensee, there are no firearms in the home.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: LANDES, SHAYNA	FACILITY NUMBER: 015700261
	VISIT DATE: 08/02/2023

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

The licensee rents the home and carries liability insurance through State Farm, the policy is valid through June 25, 2024.

On-limit-areas include: Living room, family room, kitchen, bonus room (office) one bedroom for younger children learning and napping; the main house bathroom on the right side of the home entry door, main western and southern side of the back yard and the deck. 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.
Off-limit-areas include: The remaining 4 bedrooms of the home, hallway leading the four remaining bedrooms, the house bathroom in the hall between two bedrooms, the master bathroom, attached 2-car garage, front yard and northern side of back yard. The off-limit areas will be inaccessible by closed and/or locked doors, child gates and/or by child supervision.

Children’s files were reviewed, a copy of the roster was taken for the office file. All children’s records were complete and in good order. Licensee and helper are in compliance with all immunization laws and requirements of Title 22 regulations.

The licensee’s Health and Safety training is completed, and CPR and First Aid certificate is current and expires May 8, 2025. Mandated Reporter (general) has been completed and expires 7/31/2025, a glitch in the new website did not allow licensee to renew AB1207, it is currently being done. The licensee is in compliance with the immunization laws which pertains to day care providers. LPA reminded 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.

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

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: LANDES, SHAYNA	FACILITY NUMBER: 015700261
	VISIT DATE: 08/02/2023

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

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.

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 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.

Licensee was informed of the MyChildCarePlan.org website; 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.

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

There were no deficiencies issued today.

The home has been approved as a Large Family Child Care home as of today August 2, 2023.

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

Exit interview conducted and report was reviewed with the licensee Shayna Landes.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4