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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010214703
Report Date: 05/15/2024
Date Signed: 05/15/2024 03:25:35 PM

Document Has Been Signed on 05/15/2024 03:25 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:CAMERON, COSSETTE & WILLIAMFACILITY NUMBER:
010214703
ADMINISTRATOR/
DIRECTOR:		CAMERON, COSSETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 881-8603
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY: 12TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
05/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Cossette Cameron- LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
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On 5/15/24 at 1:30pm, Licensing Program Analyst (LPA) B. Plumboy conducted an unannounced ANNUAL/RANDOM inspection. Present for the inspection was licensee, 3 infants, and 3 preschool age children. The home was toured for Health and Safety Inspection. This facility currently operates from Monday through Friday, 7:30am until 6:00pm.

The OFF LIMITS area is the garage. There is a swimming pool in the backyard with a fence surrounding the area and self latching gate. There is also another gate on the bottom stairway leading up to the pool. There are no firearms on the premises as stated by licensee. All the cleaning products during the inspection were observed to be stored and made inaccessible to the children. The fireplace is barricaded with a glass door and is not currently being used by the licensee. LPA inspected and verified that the fire extinguisher 3A40BC is fully charged, carbon monoxide detector, smoke detector and home phone are in working condition. Backyard play area is properly fenced and there are toys available for children to use during today's inspection. There are toys, learning materials and kids furniture that appeared to be well maintained during today's inspection. The licensee has completed the required training on preventive health practices including pediatric CPR and First Aid which expires on 2/19/25. Children's roster is current and available. Fire and disaster drills are being conducted regularly with the last one conducted on 4/23/24 with 5 children. The licensee is in compliance with the immunization law. The licensee completed the mandated reporter training. The licensee is aware she must document safe sleep checks while infants are asleep at least every 15 minutes.

See 809-C for continuance

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAMERON, COSSETTE & WILLIAM
FACILITY NUMBER: 010214703
VISIT DATE: 05/15/2024
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Licensee Cossette Cameron is aware she should have knowledge of all Title 22 Regulations and follow all Title 22 Regulations at all times, as well as follow manufacture guidelines for all equipment in the facility.

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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

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.

Licensee Cossette Cameron was reminded that all adults 18 and over living or working in the home, 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.

See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAMERON, COSSETTE & WILLIAM
FACILITY NUMBER: 010214703
VISIT DATE: 05/15/2024
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Licensee Cossette Cameron was informed of the MyChildCarePlan.org website; 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.

LPA discussed the safe sleep regulations with licensee Cossette Cameron 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 licensee Cossette Cameron 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.

During the exit interview, the Licensee Cossette Cameron confirmed that there are no Registered Sex Offenders living in the facility.

A notice of site visit was given and must remain posted for 30 days.

No deficiencies today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Cossette Cameron.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC809 (FAS) - (06/04)
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