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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409458
Report Date: 11/27/2023
Date Signed: 11/27/2023 03:59:38 PM

Document Has Been Signed on 11/27/2023 03:59 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:FRAGA, SANDRAFACILITY NUMBER:
073409458
ADMINISTRATOR:SANDRA FRAGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 392-8367
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
11/27/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Sandra FragaTIME COMPLETED:
04:00 PM
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On 11/27/2023 at 1:00 PM, Licensing Program Analysts (LPA) Christina Watts conducted an announced Pre-licensing Inspection and met with Applicant, Sandra Fraga who has applied for a Large Family Child Care Home with a capacity of fourteen (14). Living in the home are applicant, applicant spouse and applicant's parents. Present during inspection was applicant and applicant's parent. Days and hours of operation will be Monday – Friday from 6:00 AM - 6:00 PM.

Applicant completed 8 hour Preventative Health & Safety training, Nutrition and Lead Poisoning training, 8 hour Pediatric CPR & First Aid Certificate that expires 04/2025, has documentation for Measles, Pertussis, Influenza vaccine for the current flu season. Applicant and adults living in the home have Criminal Record and Child Abuse Index Clearance and documentation for Tuberculosis (TB) clearance. Applicant has completed and submitted certificate for Mandated Reporter training which expires 05/2025. The applicant provided proof of control of property. LPA reminded applicant that when care for more than twelve and up to fourteen is provided, Applicant must notify parents. Applicant will use the Affidavit Regarding Liability Insurance form to inform parents they do not carry a day care insurance. Applicant has a working telephone in the home. Fire Safety Clearance was given to this facility on 09/20/2023 by Inspector Nicole Dovonan of the Contra Costa Fire Protection Department.

This is a one story Home comprises of 3 bedrooms, 2 bathrooms, Living Room, Kitchen, Dining room, backyard with shed and attached garage.
Areas on limits: Living Room, Dining Room, Kitchen, Bedroom # 3, bathroom #1, middle part of backyard. Applicant will be utilizing the living room as the main room for her day care area.
Off-Limit Areas: Master bedroom (Bedroom #1), Bedroom #2, Bathroom # 2, Right side of the backyard and attached garage.
Isolation Area: Bedroom # 3 *CON'T ON PAGE 2*
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/27/2023
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: FRAGA, SANDRA
FACILITY NUMBER: 073409458
VISIT DATE: 11/27/2023
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*PAGE 2*

LPA toured the indoor space of the home. The home is sanitary and orderly, with heating and ventilation for safety and comfort. LPA observed fully charged 2A10BC fire extinguisher, working smoke, carbon monoxide detector. Medicines, cleaning products, sharp objects are stored inaccessible to children. Door access to off limit areas are made inaccessible to children. LPA reminded applicant that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care home. Applicant states there are firearms and ammunition stored in the home. LPA observed firearms and ammunition are stored separately from one another in an off limits area.

Outdoor Space: LPA toured the outdoor area. LPA observed a fully fenced and safe backyard for children in care. LPA observed safe toys, play equipment and materials observed for children. LPA observed a gated area with stairs that led to a 2nd level with an rock area with plants. LPA observed an empty bird fountain in the backyard. Applicant stated she will move bird fountain to an off limits area in the backyard. No other bodies of water were observed. LPA also observed applicant's spouse workshop and shed on the right side of the backyard that is locked and off limits. Children will be using the lower central area of backyard for outdoor activity. LPA reminded applicant when outside of facility, 100% supervision of children in care is required.

Applicant understands that children's personal rights should not be violated and nor any 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 conducted once every six months and documented. A Family Child Care Home packet was provided to and reviewed with the Applicant.



LPA discussed and reminded applicant day care needs to be operated within the limitations and capacity of a Large Family Child Care Home with regards to ratios and that Licensee has to be present in the day care for 80% of the operation hours.

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.

*CON'T ON PAGE 3*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:

DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: FRAGA, SANDRA
FACILITY NUMBER: 073409458
VISIT DATE: 11/27/2023
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*PAGE 3*

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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 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.

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.



On this date, 09/14/2023, 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.

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. *CON'T ON PAGE 4*
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:

DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: FRAGA, SANDRA
FACILITY NUMBER: 073409458
VISIT DATE: 11/27/2023
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*PAGE 4*

Website links for provider resources:
Licensing forms, Title 22 regulations, can be obtained through the internet at www.cdss.ca.gov
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.

Facility is recommended for licensure, subject to submitted plan of correction. License will be pending until applicant submit verification of experience letter to licensing.

The following items to be completed prior to licensure:
1) Proof of Experience Letter

Exit interview was conducted with Applicant, Sandra Fraga and signed the report acknowledging receipts of documents.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:

DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4