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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409136
Report Date: 03/03/2021
Date Signed: 03/03/2021 02:02:37 PM

Document Has Been Signed on 03/03/2021 02:02 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:STOWE, FREDAFACILITY NUMBER:
073409136
ADMINISTRATOR:STOWE, FREDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 867-8259
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/03/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:FREDA STOWETIME COMPLETED:
12:00 PM
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10:00AM: Licensing Program Analyst Alexander met today with Freda Stowe for an ANNOUNCED RE-LOCATION tele inspection via zoom meeting call due to COVID-19 pandemic. Applicant is the only one present for the inspection. The home is a one story house consisting of 3 bedrooms, 2 bathrooms, living room, bonus room/den, kitchen/dinning room and garage. The living room, bonus room/den, kitchen/dinning room, hall bathroom and backyard will be used as the primary areas for day-care. The off limit areas will be all 3 bedrooms, garage, the shed located in the backyard as well as the deck/patio which is fenced off. These areas will be inaccessible to children in care by closed/and or locked doors and visual supervision. Applicant and her adult daughter own the home; proof was shown. There is a 3A40BC fire extinguisher and working smoke detector/carbon monoxide combo; recommended periodic servicing. Per applicant, there are no firearms in the home. There are no pools, hot tubs or other bodies of water at the home. All sharp knives, cleaning solutions and medications are inaccessible to children. First aid kit is available and complete. The isolation area for sick children will be an area located in the living room. Outdoor play will be in the backyard which is completely fenced. There are toys and play space available. Applicant was instructed to conduct and document periodic fire and disaster drills. Applicant was informed that baby walkers, exersaucers and baby bouncers are not allowed. Applicant has completed CPR and First aid training which expires 1/2023. Applicant has completed her 16 hours of health and safety training which included the 1 hour of nutrition and lead poisoning training..

Mandated reporter and appeal rights were discussed. Licensing forms were reviewed and copies given to applicant. Applicant was instructed on the law establishing a $100 fine per day for adults who are living in the home or who are providing care who do not have fingerprint clearances. Applicant was also instructed on the law requiring notification to parents regarding exclusions.

CONTINUED ON 809-C
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2021
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: STOWE, FREDA
FACILITY NUMBER: 073409136
VISIT DATE: 03/03/2021
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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 the ADA, available at: http://www.ada.gov/childqanda.htm

ALL COVID-19 POSTINGS GUIDELINES DISCUSSED AND MATERIALS WERE EMAILED TO APPLICANT. THE SELF-ASSESSMENT GUIDE HAS BEEN REQUESTED.

As a result of this visit, there are no deficiencies cited today. This report must be available for public review for 3 years. An exit interview was conducted. A copy of this report has been emailed to licensee.



THIS HOME WILL BE LICENSED FOR A LARGE FAMILY CHILD CARE HOME EFFECTIVE TODAY 3/3/21.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2021
LIC809 (FAS) - (06/04)
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