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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013414163
Report Date: 11/08/2023
Date Signed: 11/08/2023 11:36:44 AM

Document Has Been Signed on 11/08/2023 11:36 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:FRANKLIN, MAVISFACILITY NUMBER:
013414163
ADMINISTRATOR:FRANKLIN, MAVISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 638-7008
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 3DATE:
11/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Mavis FranklinTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Cherie Acosta and Licensing Program Manager (LPM) Sherelle Johnson conducted an informal meeting at licensee's home. LPA and LPM met with licensee Mavis Franklin.
The purpose of the meeting was to discuss incidents that occurred at the home during child care hours. There was an incident where a child wandered away from the home with out licensee's knowledge.There was also a verbal and physical altercation between parents/authorized representative of children in care in the presence of children.

Licensee stated during today's meeting that she understands the importance of ensuring gates are kept close and children have adequate supervision to ensure their safety at all times. Licensee was reminded of the requirement to report all unusual incidents to Community Care Licensing (CCL) within 24 hours and to submit a written unusual incident report to CCL within 7 days.

Also discussed with Licensee was the the importance of her and her husbands communication and professional relationship with CCL staff, parents and children in care.

During the inspection on 10/12/23, LPA felt her personal space was violated by adult in the home touching her on the arm. Licensee was reminded of her and her spouse conduct when dealing with children, parents and CCL staff. LPA provided Licensee with the H&S code 1596.885(c) Conduct Inimical. Licensee states she understands and agrees with what was discussed today and will contact LPA if she has any questions or concerns.

An Exit interview was conducted with Licensee Mavis Franklin. Provided was her appeal rights and a notice of site visit.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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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