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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073402400
Report Date: 06/01/2023
Date Signed: 06/01/2023 03:10:25 PM

Document Has Been Signed on 06/01/2023 03:10 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:SAENZ, SANDRAFACILITY NUMBER:
073402400
ADMINISTRATOR:SAENZ, SANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 234-1349
CITY:RICHMONDSTATE: CAZIP CODE:
94804
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
06/01/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:17 PM
MET WITH:Sandra SaenzTIME COMPLETED:
03:25 PM
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On Thursday, June 1, 2023 1:45 PM, Licensing Program Analyst (LPA) Caroline Colson met with Sandra Saenz for an unannounced Random Annual Inspection. There are five (5) preschool children, one (1) infant and two (2) school children present. The facility's operating hours are Mondays - Fridays from 7:00 AM to 6:00 PM. LPA toured the facility for a health and safety inspection.

Indoor Space: The home is a two story home. The first floor includes a kitchen with dinning area, family room, 2 downstairs bedrooms, 3 downstairs bathrooms, downstairs closet and two offices. The second floor includes 2 bedrooms, one bathroom and a family room. There is an unfenced front yard and fenced back yard. The fenced back yard will not be used temporarily until construction is completed. There is heating and ventilation for safety and comfort. The Isolation Area will be is the kitchen. There is ample amount of toys available. Per Sandra Saenz, there are no guns in the home. All hazardous materials and toxins are stored away from children. The home is equipped with a 2A10BC fire extinguisher, working smoke detector and working carbon monoxide detector. Emergency Disaster Plan is current and posted. Mrs. Saenz has current Pediatric CPR/First Aid certificates which expire on September 16, 2023. Mandated Reporter Training certificate is current and expire on April 14, 2024. There is 1 bird.

Off Limit Areas: The entire second floor, 2 downstairs bedrooms, 2 downstairs bathrooms, downstairs closet and 2 offices.

Outdoor Space: The children will go to the neighborhood park for outdoor play. There are no pools, hot tubs or any other bodies of water on the premises.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE: DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/01/2023
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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SAENZ, SANDRA
FACILITY NUMBER: 073402400
VISIT DATE: 06/01/2023
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·CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

· Licensees and all staff are Mandated Reporters and are required to report to CCLD any suspected child abuse.



CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov

· Licensees may register to receive child care updates: www.myccl.ca.gov

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 ADA, available at: http://www.ada.gov/childquanda.htm

Please See LIC 809 C for Additional Information

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023
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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SAENZ, SANDRA
FACILITY NUMBER: 073402400
VISIT DATE: 06/01/2023
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Family Child Care Homes

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.

Safe Sleep

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee, Sandra Saenz 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.

Notice of Site Visit

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

Exit Interview

Exit interview conducted and report was reviewed with the licensee, Sandra Saenz.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023
LIC809 (FAS) - (06/04)
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