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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015701063
Report Date: 03/21/2024
Date Signed: 03/21/2024 11:57:28 AM

Document Has Been Signed on 03/21/2024 11:57 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:SANTOS, SUSANAFACILITY NUMBER:
015701063
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
03/21/2024
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Susana SantosTIME COMPLETED:
12:05 PM
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On March 21st, 2024 at approximately 10:00am, Licensing Program Analyst (LPA) April Wright met with licensee Susana Santos for the purpose of an Increase in Capacity Inspection. Present during the inspection were two (2) Infant children, Licensee fingerprint cleared mother Maria Rodriguez and daughter Madeline Santos. The home was toured for health and safety inspection. Hours of operation are 7:30am - 5:00pm Monday through Friday.

The single story home consists of three (3) bedrooms, two (2) bathrooms (including master bathroom), Living room, Dining area, kitchen, garage, and backyard. The home is neat and orderly with heating and ventilation for safety and comfort. The fireplace remains barricaded by a bookcase which makes it inaccessible to children in care. There are age appropriate toys and furniture available for children in care. Child safety locks remain on all the doors that are in the off limits areas and cabinets. Licensee has small square shaped fish aquarium on the kitchen counter which is not accessible to children in care.

On limits areas: Living room (main day-care room), Dining Area (day-care room #2), Bathroom #1 (down hallway to the right) Master bedroom (bedroom #2 - Nap Room - down hallway to the right), Kitchen and backyard. The backyard is fully fenced and is free of defects, hazards and damage. The large cactus plant in the backyard remains inaccessible to children in care by a child safety gate surrounding it. LPA advised licensee to keep visual supervision in that area until it can be removed. Licensee will update LPA upon it's removal from the yard.

Off limit areas: Off limits areas will be made inaccessible by closed/locked doors, safety gates/locks and visual supervision. Off limit areas include Bedroom #1(left of hallway) and #3 (Right of hallway) and garage. LPA observed and Licensee confirmed that there are no pools, hot tubs, bodies of water, hazardous materials, including cleaning products or toxins present during the inspection or accessible to children in care. The home has a fully charged 2A10BC fire extinguisher, carbon monoxide detector, and installed pull down fire alarm. Per licensee there are no weapons or firearms present in the home. See LIC809C for continuance.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2024
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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SANTOS, SUSANA
FACILITY NUMBER: 015701063
VISIT DATE: 03/21/2024
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Capacity Increase: All requested/required documents were received for the increase in capacity application and verified by the LPA on 3/4/2024. The fire clearance for a capacity of 14 was approved by the Fremont Fire Department and received by CCLD via fax on 3/18/2024. The Licensee is reminded to abide by the conditions of the fire clearance which states that day care children are not permitted in the garage. Pull down fire alarm is located in Day care room #2 on the right side of the wall, near the exit door to the back yard. The licensee was reminded that an assistant must be present at ALL times when there is more than 8 children in attendance. Whenever the assistant is not present, the licensee will comply with the capacity requirements for a small family child care home. A copy of Capacity Requirements for a Family Child Care Homes were reviewed and given to licensee. Licensee understands the capacity requirements for their family childcare home.
Assistant Requirements: LPA discussed with licensee the requirements and documents required for an assistant to be working and present with children in care. LPA advised licensee to have completed and received all documents prior to the assistants first day of employment in the family child care home. When the licensee has an assistant, the licensee will ensure that the assistant has the following documents and placed in a personnel file for review: 1) Mandated Reporter certificate for Child Care Providers, 2) Criminal Record Clearance and associated to the facility (Guardian), 3) Proof of immunization against Measles (MMR) & Pertussis (Tdap), 4) Proof of TB Clearance, & 5) Signed copy of the Statement Acknowledging Requirement to Report Child Abuse (LIC 9108) Form. CPR & First Aide is required if the assistant is left alone with the children.

The home is recommended for an increase of capacity of up to 14 children.

A notice of site visit of given was given and must be posted for 30 days. Exit interview was conducted and report was reviewed with the licensee Susana Santos.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024
LIC809 (FAS) - (06/04)
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