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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013413941
Report Date: 10/23/2023
Date Signed: 10/23/2023 12:43:22 PM

Document Has Been Signed on 10/23/2023 12:43 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:RODRIGUEZ, IRMA & MORALES FELIX, DUNIAFACILITY NUMBER:
013413941
ADMINISTRATOR:RODRIGUEZ, IRMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 656-6530
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
10/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Irma RodriguezTIME COMPLETED:
12:50 PM
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On 10/23/2023 at 10:00AM Licensing Program Analyst (LPA) Jaleesa Jackson arrived at for an Unannounced Annual Inspection and met with Licensee Irma Rodriguez. LPA informed Licensee of the nature of the visit and was granted entry into the home. Present for this inspection was the Licensee, Licensee's fingerprint cleared husband, Licensees fingerprint cleared daughter, eight (8) preschool aged children, and two (2) infants. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8AM to 5PM

ON LIMITS: bathroom #1(hallway bathroom on right), fenced backyard, living room (isolation area), dining room, main day care area and left side yard (main entrance for day care children) and kitchen.
OFF LIMITS: garage, all four bedrooms, front yard, right side yard, two outdoor sheds, and family room. Off limit areas are inaccessible by closed and/or locked doors, gates, and visual supervision.

The home is single story, which is neat with heating and ventilation for safety and comfort. The main entrance to the day care is the fence on the left side of the house. At 10:05AM, LPA observed there were ample age appropriate toys that were observed to be safe and in good condition. At 10:15AM Co-licensee Dunia Morales Felix arrived at the home. There is a fully charged 2A10BC fire extinguisher, working carbon monoxide, smoke detectors, and telephone. The home has a fireplace but is blocked off. LPA observed two Lysol products left next to the changing table after the children went outside to play. LPA informed licensee that the cleaning products need to be but on a higher shelf after use to make them inaccessible to children. Licensee put the cleaning products away in a locked cabinet so they would be inaccessible to children. Licensee stated there are no firearms and no one smokes at the home. The facility has a small dog and water fountain in the front yard that is OFF limits to children. The facility does not provide meals to children. All children bring their own snacks and lunches from home.

Continued on LIC809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2023
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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: RODRIGUEZ, IRMA & MORALES FELIX, DUNIA
FACILITY NUMBER: 013413941
VISIT DATE: 10/23/2023
NARRATIVE
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All required licensing documents are posted and visible for public review. At 10:40AM, 10 children's files were reviewed and found that 3 files were not complete. Both infants in care did not have sleep logs, one file was missing the infant sleep plan (LIC 9227), and one child is missing the signature on LIC627. LPA reminded Licensees of the importance of keeping daily sleep logs for all infants under the age of 2 years old. LPA gave Licensees a copy of the LIC9227 and explained to Licensees that this form needs to be filled out for all infants enrolled under the age of 1 years old. The facility roster was reviewed and a copy obtained. The licensee is in ratio today. Both licensees have expired mandated reporter certificates. LPA reminded Licenees that mandated reporter needs to be renewed every 2 years. Both licensees have current CPR and first aid that expire 01/01/2024. The licensee conducts and documents fire drills and the log indicates a drill was conducted 07/12/2023.

There were no deficiencies cited on today's visit.

Licensees were reminded that California Law requires Licensee to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov. Licensee was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting http://www.mandatedreporterca.com.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Continued 809-C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023
LIC809 (FAS) - (06/04)
Page: 2 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: RODRIGUEZ, IRMA & MORALES FELIX, DUNIA
FACILITY NUMBER: 013413941
VISIT DATE: 10/23/2023
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Family Child Care Homes Licensees were 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.

LPA discussed the safe sleep regulations with licensees 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 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 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)/ (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/.

Licensees were 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.



During the exit interview, the Licensees Irma Rodriguez and Dunia Morales Felix, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted and report was reviewed with the licensees Irma Rodriguez and Dunia Morales Felix.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023
LIC809 (FAS) - (06/04)
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