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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409228
Report Date: 01/13/2022
Date Signed: 01/13/2022 01:56:10 PM

Document Has Been Signed on 01/13/2022 01:56 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:BONIN, SUSANFACILITY NUMBER:
073409228
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
01/13/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Susan BoninTIME COMPLETED:
02:00 PM
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On 01/13/2022 at 10:30 AM Licensing Program Analyst(LPA), Arminder Singh conducted an announced Pre-Licensing Inspection and met with Applicant, Susan Bonin. Applicant resides in the home with her fingerprint cleared Husband. During the inspection the Applicant was home.

Applicant has applied for a Small Family Child Care Home with capacity for 8 children. Days and hours of operation will be Monday through Friday from 8:30 AM - 12:00 PM. Applicant has current Pediatric cardiopulmonary resuscitation (CPR) and First Aid and has current mandated reporter training. Applicant currently owns this property. Applicant has a working telephone in the home (925-683-0829). Isolation of sick child was discussed and the front of the school room #2 will be the isolation area. Applicant understands that 100% supervision is required at all times. Entrance to the facility and where parents will drop off children is through the left side gate.

LPA toured the indoor space of the home with the Applicant. The home is a one story home with an attached garage. The home consists of four bedrooms, three bathrooms, kitchen, two living rooms, dining room, nook,study room, and backyard.

IN USE AREAS: Bedroom #1 (school room #1), Bedroom#2 (school room #2), and bathroom located in school room#2.

OFF LIMIT AREAS: Bedroom #3, Master Bedroom, Bathroom #2 located in hallway, Bathroom #1 located in Master Bedroom, both living rooms, dining room, kitchen, nook,study room, and garage.

CONTINUED ON NEXT PAGE


SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2022
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: BONIN, SUSAN
FACILITY NUMBER: 073409228
VISIT DATE: 01/13/2022
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The home is sanitary, safe and orderly, with central heating and ventilation for safety and comfort. There is a fireplace in the home that is properly barricaded and made inaccessible to children and is in an Off Limit area of the home. LPA observed: fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detector. Medicines, cleaning products, sharp objects are stored inaccessible to children in cabinets and out of reach of children. LPA reminded Applicant that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. Applicant states there is a firearm that is located in the attic and is only accessible through the master bedroom closet ceiling. The attic is only accessible with a ladder. The firearm does not have ammunition. Applicant states there is no ammunition for this firearm on the premises. Applicant states there is no pets in the home.

Outdoor Play area is fully fenced which has two patios, lawn area, and a covered swimming pool. The pool has a mesh covering that can with stand weight up to 250 pounds. The applicant demonstrated the cover is secure by walking over it and also submitting documents from the company that installed the cover. The outdoor area does have two sheds that are located to to the right side of home and are made inaccessible by a lock. Applicant understands that children are not allowed to walk over the pool covering and 100% supervision is required at all times.

Applicant understands that children's personal rights should not be violated and no corporal punishment. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries and requirements for assistant/substitute were also discussed. Fire drills must be practiced once every six months and documented.

Licensee was reminded that all adults 18 years of age 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.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022
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: BONIN, SUSAN
FACILITY NUMBER: 073409228
VISIT DATE: 01/13/2022
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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 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.


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

LPA discussed Assembly Bill (AB) 1207 (Mandated Child Abuse Reporting Training) which is required training that began on January 1, 2018 and requires renewal every two years, AB 633 was discussed with Applicants. Licensing forms, Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov. Mandated Reported Training can be accessed at www.mandatedreporterca.com.


CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022
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: BONIN, SUSAN
FACILITY NUMBER: 073409228
VISIT DATE: 01/13/2022
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Website for provider resources:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

Email to this:

childcareadvocatesprogram@dss.ca.gov


This home is recommended for licensing effective 01/13/2022. LPA reminded the applicant that compliance with all Title 22 regulations and applicable Health and Safety regulations, must be maintained at all times.

Exit interview was conducted and report was reviewed with the Licensee, Susan Bonin.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022
LIC809 (FAS) - (06/04)
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