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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407225
Report Date: 08/10/2023
Date Signed: 08/10/2023 03:33:50 PM

Document Has Been Signed on 08/10/2023 03:33 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:MOLINA, EDITHFACILITY NUMBER:
073407225
ADMINISTRATOR:MOLINA, EDITHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 325-5733
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 7DATE:
08/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Edith MolinaTIME COMPLETED:
04:00 PM
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On 08/10/23 at 1:00pm, Licensing Program Analysts (LPAs) Ashley Akinleye and Christina Watts arrived at the home for an unannounced Required - 1 year inspection / random inspection. LPA met with Edith Molina. There were 7 preschool children in care during the inspection. Licensee stated that she only cares for children ages 3-5 years old. This family childcare home operates Tuesday - Friday 7:30a -4:30p. LPA verified that the licensee's phone number and email address on file are correct.
LPAs toured the home with Edith Molina, to conduct a health and safety inspection. The home is a two story home, and consists of 4 bedrooms, 3 bathrooms, living room, kitchen, dining area, garage and family area. LPAs observed that the home is neat and clean with heating and ventilation for the safety and comfort of children in care. The on-limit areas include entire downstairs (one bedroom, living room, kitchen, dining room, family room, bathroom), converted garage and middle/right side of backyard. The off-limit areas include left side of backyard, the entire second floor of home; 3 bedrooms, 2 bathrooms, laundry room and second floor loft. These areas are made inaccessible by closed and/or locked doors, gates, and visual supervision. LPA observed locks on lower cabinets to prevent access by children. The downstairs bedroom is used for isolation of sick children, away from other children in care. The fireplace in the living room is blocked to prevent access by children. The left side and central area of back yard is used for outdoor play and front yard and left side of backyard is off limits. LPAs did not observe any hazards or dangerous conditions in either yard. LPA observed an ample supply of age-appropriate toys, equipment and activities available for children both indoors and outdoors and observed that they are in good condition. LPAs did not observe any bodies of water, toxins, medications or hazardous items that would be accessible to children. The licensee stated that there are no firearms on the premises.
The home is equipped with fully charged 3A40BC fire extinguishers, a working carbon monoxide detector, working smoke detector, working telephone, and first aid kits and supplies. Licensee has proof of current CPR/First aid certificates, which expire on 01/2025. The last documented fire drill was conducted on 4/11/23. LPAs observed all of the required forms posted. LPAs reviewed children's files, staff files and obtained a copy of the current roster.
This Report Continues on 809-C
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2023
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: MOLINA, EDITH
FACILITY NUMBER: 073407225
VISIT DATE: 08/10/2023
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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 CARE tools, please send email inquiries 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 Edith Molina was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPAs discussed the safe sleep regulations with licensee Edith Molina and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or 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.

LPAs reminded the licensees that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. LPA provided the main office number for the Oakland Regional Child Care office (510) 622-2602 for the licensees to call and report injuries or unusual incidents and reviewed the form to follow up in writing within 7 days of the injury/unusual incident. The licensees were encouraged to periodically review regulations, guidelines and Provider Information Notices (PINs) on the website www.ccld.ca.gov.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: MOLINA, EDITH
FACILITY NUMBER: 073407225
VISIT DATE: 08/10/2023
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Report Continues

Licensee Edith Molina was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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

LPA reminded the licensee that the mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

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

Exit interview conducted and report was reviewed with the licensee Edith Molina.

Page 3

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023
LIC809 (FAS) - (06/04)
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