073409439-10-20-2023-02-CC-SBLE-CWSNLE-20231020103324

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409439
Report Date: 10/20/2023
Date Signed: 10/20/2023 10:33:33 AM

Document Has Been Signed on 10/20/2023 10:33 AM - 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:	ESGUERRA, DENNIE BRIGETTE		FACILITY NUMBER:	073409439
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 2	DATE:	10/20/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Dennie Brigette Esguerra		TIME COMPLETED:	10:45 AM

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On 10/20/23 at 8:30am, Licensing Program Analyst (LPA) Sikia Blue arrived at the facility for an announced prelicensing inspection. LPA met with Dennie Brigette Esguerra. Present in the home was Applicant, Mother Connie Pille and two minor children. This family child care home will operate Monday through Friday from 6am to 6pm and will keep ages 0-5. LPA verified the applicant's phone number and email on record are correct.

LPA toured the home with the applicant, to conduct a health and safety inspection. LPA observed that it is neat and clean with heating and ventilation for the safety and comfort of children. The home has 4 bedrooms 3 1/2 bathrooms and is a two story family home, which consists of the living room, dining room, laundry room, kitchen, a loft, 4 bedrooms, 3 1/2 bathrooms, garage, and backyard . The ON LIMITS areas include the living room, the dining room, downstairs bedroom, two downstairs bathrooms, and the backyard for outdoor play. OFF LIMITS areas include the entire upstairs which consist of the loft, 3 bedrooms, 2 bathrooms, laundry room, and downstairs kitchen, the garage and has been made inaccessible by gates, closed and/or locked doors and visual supervision. The dining room area will be used for isolation of sick children. LPA observed an ample supply of age appropriate toys, activities and equipment for children, which appeared to be safe and in good condition. LPA did not observe any medication, bodies of water, hazardous items or poisons accessible to children during the inspection today. The applicant stated there are no firearms in the home.

The home is equipped with 2 fully charged fire extinguishers a 3 A 40 BC and a 1 A 10 BC, six working combination smoke and carbon monoxide detectors, working telephone, and first aid kits. The applicant completed the preventative health and safety training which includes 1 hour of nutrition and lead component 4/22/23. The applicant completed the CPR and First Aid training and was issued a certificate that expires in 4/2025. The licensee has completed the required mandated reporter training, and it will expire on 8/04/25. Applicant stated food will be provided (Breakfast, snack, lunch, and afternoon snack). Applicant was informed about nutritional regulations.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023

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: ESGUERRA, DENNIE BRIGETTE	FACILITY NUMBER: 073409439
	VISIT DATE: 10/20/2023

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LPA reviewed all of the forms required for the children's files, facility file, posting and other information related to Licensing and the care of children, and left copies with the applicant. LPA advised that applicant of where to obtain additional copies of the forms. The applicant stated that she will have documents posted right by the lower level backyard door, and LPA observed the area where the board will be mounted on the wall. LPA reminded the applicant that the required documents must be visible for the public at all times during hours of operation.

LPA reviewed children's personal rights and the applicant advised that she understands that children's personal rights should not be violated and no corporal punishment. LPA discussed supervision of children, capacity/ratio options, transportation of children, and requirements for an assistant/substitute. LPA reminded the applicant that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. LPA reviewed fire/earthquake drill information, and how to complete the drill log. LPA demonstrated how to fill out the immunization record for children's files, discussed the applicant's responsibility to ensure the records are up to date and have discussions with parents/guardians if they are not, and advised that it does not need to be done if children are enrolled in school. LPA reminded the applicant to report any injuries requiring medical attention or unusual incidents to the Oakland Regional Child Care office. LPA reviewed the form to follow up in writing within 7 days of the injury/unusual incident. The applicant was encouraged to periodically review regulations, guidelines and PINS on the website www.ccld.ca.gov.

LPA verified that the applicant, and all other adults living in the home, have a criminal record clearance and are associated to the license.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

The applicant provided proof of control of property.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023

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: ESGUERRA, DENNIE BRIGETTE	FACILITY NUMBER: 073409439
	VISIT DATE: 10/20/2023

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LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

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) or (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 reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPA discussed the safe sleep regulations with applicant 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 applicant 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.

On 3/24/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023

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: ESGUERRA, DENNIE BRIGETTE	FACILITY NUMBER: 073409439
	VISIT DATE: 10/20/2023

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Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

This facility will be licensed as of today 10/20/2023

Exit interview conducted and report was reviewed with the applicant Dennie Brigette Esguerra.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023

LIC809 (FAS) - (06/04)

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