073409551-8-8-2024-02-CC-MCAO-D7XPKH-20240808112309

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409551
Report Date: 08/08/2024
Date Signed: 08/08/2024 11:23:28 AM

Document Has Been Signed on 08/08/2024 11:23 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:	SAMOEIL, DIMYANA		FACILITY NUMBER:	073409551
ADMINISTRATOR/ DIRECTOR:	DIMYANA SAMOEIL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 732-8237
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94531
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 1	DATE:	08/08/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Dimyana Someil		TIME VISIT/ INSPECTION COMPLETED:	11:35 AM

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On 08/08/24 Licensing Program Analysts (LPA) Mario Caro and (LPA) Julia Placencia met with applicant Dimyana Samoeil and conducted an ANNOUNCED PRELICENSING VISIT. The home was toured to conduct a Health and Safety Inspection. Present during the inspection were applicant, her husband, and infant son. LPAs disclosed the purpose of the inspection and were granted entry into the facility by applicant. This facility plans to operate Monday - Friday, 7:30am - 5:00pm, depending on the need for care, but will not exceed 24 hours in one day.

Applicant has completed the 8 hour Health & Safety training, Pediatric CPR and First Aid on 02/05/2024, has documentation for Measles, Pertussis immunization, Influenza and Tuberculosis clearance (proof in facility file). Applicant completed the mandated reporter training on 07/11/2024. Applicant owns the home and submitted a copy of the deed. Because the applicant owns the home, proof of landlord notification/consent are not required.

LPAs reminded applicant that when care for more than six and up to eight is provided, applicant must notify parents and utilize the parent notification form LIC9150. Applicant doesn’t have Liability Insurance. Applicant states she will carry liability insurance so LIC282 affidavit will not be in the children’s files.

The home is a single story house which consists of three bedrooms, two bathrooms, a garage, kitchen, living room, dining room, laundry room, and backyard. The home is sanitary, safe and orderly, with ventilation for safety and comfort. LPAs observed: fully charged fire extinguisher 2A-10-BC, working telephone, first aid supplies, and working smoke and carbon monoxide detectors. There isn't A fireplace in the home. Medicines, cleaning products, sharp objects are stored inaccessible to children in cabinets. LPAs reminded Applicant that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes.

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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

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: SAMOEIL, DIMYANA	FACILITY NUMBER: 073409551
	VISIT DATE: 08/08/2024

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Applicant states there are no firearms or ammunition stored in the home. LPAs observed age-appropriate toys. LPAs did not observe any medications, bodies of water, poisons or hazardous items that would be accessible to children.

Indoor Space:

ON LIMIT: The entry way hallway, play area in the garage enclosed by a child safe gate (first door on the right of the hallway), play room first opening on the left of the hallway (the room on the left side), the bathroom in between the two rooms, the living room, kitchen, dining room, and backyard. Applicant understands children can only be in the garage for a short time for activities and there is no eating, drinking, or napping permitted. The gazebo area of the backyard will be on limits.

OFF LIMIT: The bedroom on the right of the left opening in the hallway (sons bedroom), the laundry room, master bedroom, master bathroom, area outside of the gated play area in the garage, and all closets. All off limit areas shall be maintained with child proof handles..

Isolation area: The isolation area will be in the living room.

Discipline policy was discussed, and Applicant stated she will talk to the children as form of discipline. 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. Applicant understands that she must be present in the home during 80% of the operating hours of the day care and ensure that the children are supervised at all times. The licensee understands her capacity options and that she cannot have more than 14 children in the home at any time. Applicant may offer transportation services for children drop off and pick up.

LPAs 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. A Family Child Care Home packet was provided to the Applicant.

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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

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: SAMOEIL, DIMYANA	FACILITY NUMBER: 073409551
	VISIT DATE: 08/08/2024

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LPAs reminded the applicant to report any injuries requiring medical attention or unusual incidents to the Oakland Regional Child Care office. The applicant was encouraged to periodically review regulations, guidelines and PINS on the website www.ccld.ca.gov.

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.

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.

LPAs provided the applicant with information on the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPAs also informed the 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 04/17/2024 , 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.

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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

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: SAMOEIL, DIMYANA	FACILITY NUMBER: 073409551
	VISIT DATE: 08/08/2024

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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.

LPAs recommended 100% supervision while children are in the backyard.

The following corrections shall be made before the home is ready for licensure:

Child proof handles need to be purchased and placed on all off limit door handles.
These corrections shall be submitted by providing pictures within ten days of this report.
LPA may visit facility to confirm corrections are complete.
.
Exit interview conducted and report was reviewed with the applicant, Dimyana Samoeil.

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SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

LIC809 (FAS) - (06/04)

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