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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700341
Report Date: 06/25/2024
Date Signed: 06/25/2024 12:38:59 PM

Document Has Been Signed on 06/25/2024 12:38 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:COLLVER, LISAFACILITY NUMBER:
015700341
ADMINISTRATOR/
DIRECTOR:		COLLVER, LISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 552-7187
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
06/25/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Lisa CollverTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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On June 25, 2024 at 9:30am Licensing Program Analyst (LPA) Randy Miranda arrived unannounced for a 1-Year Required annual inspection. Present in the home today was licensee Lisa Collver, her fingerprint cleared assistant Phoebe Collver Freeland, and 7 children in care (1 infant; 2 four years old; 2 three years old; 1 2.5 years old; and 1 11 years old). The facility is in ratio today. The home was toured to conduct a health and safety inspection. The home is neat and clean with heating and ventilation for safety and comfort. Hours of operation for day care are Monday through Friday, 8:00am to 6:00pm.

The home is a single-story ranch stye house with 3 bedrooms, 2 1/2 bathrooms, kitchen, (plus a nook); a “great room” (former dining room with a fireplace now a play area), a living room (play area), a children’s ½ Document Link Iconbath and attached 2-car garage. There is a large backyard play area divided up into 5 sections with farm animals and play structures. There are 3 pigs, 1 goat, (one goat has grown horns and as a result the pen is off limits to children). The perimeter of the property is surrounded by a fence. Licensee also has 2 cats, who have current vaccinations. There are ample age appropriate toys.

Toxins, medicines, and hazardous items were inaccessible. Facility has a waiver for a woodburning stove.

ON LIMIT AREAS: Kitchen; dining room (great room); living room (play/activity room); 1/2 bathroom near front door, bedroom for napping infant off of the great room; backyard and front yards.

OFF LIMITS: The remainder of home: 2 back bedrooms, 2 bathrooms; attached 2-car garage; Mother-In-Law Quarters; goat and pig pens in back yard area. Off limit areas are inaccessible by closed and/or locked doors and visual supervision. The outdoor play area and child playhouses were found to be free from defects or dangerous conditions.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024
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 5
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: COLLVER, LISA
FACILITY NUMBER: 015700341
VISIT DATE: 06/25/2024
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There are ample age appropriate toys in good condition and activities available for children. LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during the inspection.

The home has a fully charged 2A10BC fire extinguisher mounted on the wall of the great room; smoke detectors and carbon monoxide detectors were present; tested and working. There is a woodburning fireplace in the great room (day care area) with a waiver to not be used during childcare operations; always be cool to the touch, and a screen to prevent access to children. Liability insurance supplied by Assure/Hayes is current through 1/07/2025. If a child becomes ill during care, the isolation area will in the living room (play/activity room) away from the other children in care.

The licensee’s Health and Safety training is completed. Licensee’s CPR and First Aid certificate are current through 05/2025. Licensee's assistant has an expired Mandated Reporter (02/28/2022) therefore, a technical violation was issued. Mandated Reporter is expired for staff – see LIC9102 for Techinal Violation. Licensee and all staff are in compliance with immunization laws pertaining to family day care homes.

Licensee was reminded that CPR/1st Aide and Mandated Reporter training is to be 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 files were reviewed, a roster was available and a photocopy taken by LPA for the office file.

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.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2024
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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: COLLVER, LISA
FACILITY NUMBER: 015700341
VISIT DATE: 06/25/2024
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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 [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.

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 1 Technical Violation issued today, see LIC9102 for details:


Mandated Reporter certificates for all staff are expired and need to be renewed (AB1207)

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

Exit interview conducted and report was reviewed with the licensee Lisa Collver.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2024
LIC809 (FAS) - (06/04)
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