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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409074
Report Date: 02/21/2024
Date Signed: 02/21/2024 12:32:22 PM

Document Has Been Signed on 02/21/2024 12:32 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:OCAMPO, ROBERTOFACILITY NUMBER:
073409074
ADMINISTRATOR:OCAMPO, ROBERTOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 861-7971
CITY:RICHMONDSTATE: CAZIP CODE:
94804
CAPACITY: 14TOTAL ENROLLED CHILDREN: 15CENSUS: 12DATE:
02/21/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ana CastroTIME COMPLETED:
12:45 PM
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On 2/21/2024, at 9AM, Licensing Program Analyst (LPA) Brittany Crass arrived at the home for an unannounced required/random inspection. LPA met with the licensees' daughter, Ana Castro. There were 2 infants and 10 preschool aged children in care during the inspection. This family childcare home operates Monday - Friday 8am-5pm. LPA verified that the licensees' phone number and email address on file are correct. The facility has a dog and two cats.

LPA toured the home with Ana Castro, to conduct a health and safety inspection. LPA observed that the home is neat and clean with heating and ventilation for the safety and comfort of children in care. The home is a single story home. The on-limits areas include the living room, kitchen, bathroom, and fenced backyard. The off-limit areas are made inaccessible by closed and/or locked doors, gates, and visual supervision. A section of the living room is used for isolation of sick children, away from other children in care. The front and back yards are both fully fenced. 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. Ana Castro stated that there are no firearms on the premises.

The home is equipped with fully charged 3A40BC fire extinguisher, and a working smoke detector. The carbon monoxide detector did not have batteries installed when LPA arrived, but licensee replaced the batteries during the visit. (See 809-D for deficiency cited during todays visit). Licensee has proof of current CPR/First aid certificates, which expire on 7/24/2025 and a mandated reporter certificate which expires on 7/14/2025. The last documented fire drill was conducted on 11/2/2023. LPA observed all of the required forms posted. LPA reviewed children's files, staff files and obtained a copy of the current roster.

Report continued (see 809-C).

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Brittany Crass
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: OCAMPO, ROBERTO
FACILITY NUMBER: 073409074
VISIT DATE: 02/21/2024
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The licensee and facility representative 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.

LPA discussed the safe sleep regulations with the licensee and facility representative 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 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.

LPA reminded the licensee 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/.

Licensee and facility representative 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.

(Report continued, See 809-C)

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Brittany Crass
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
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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: OCAMPO, ROBERTO
FACILITY NUMBER: 073409074
VISIT DATE: 02/21/2024
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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.

The facility representative 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.

See 809-D for deficiencies cited during todays visit.

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

Appeal rights provided and discussed.

Exit interview conducted and report was reviewed with the licensee Roberto Ocampo and the facility representative Ana Castro.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Brittany Crass
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/21/2024 12:32 PM - It Cannot Be Edited


Created By: Brittany Crass On 02/21/2024 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: OCAMPO, ROBERTO
FACILITY NUMBER: 073409074

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above by not having batteries in the carbon monoxide detector, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/22/2024
Plan of Correction
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Licensee immediately put batteries in the carbon monoxide detector while LPA was at the facility, correcting the deficiency.
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in 2 out of 2 infants' records by not having the 15 minute sleep check log, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/28/2024
Plan of Correction
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Licensee will email LPA Crass a photo showing one week of 15 minute sleep log checks for all infants in care.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Loretta Dyson
LICENSING EVALUATOR NAME:Brittany Crass
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024


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