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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416181
Report Date: 07/17/2023
Date Signed: 07/17/2023 02:01:28 PM

Document Has Been Signed on 07/17/2023 02:01 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:RUSSELL-JONES, TAMMIEFACILITY NUMBER:
013416181
ADMINISTRATOR:RUSSELL-JONES, TAMMIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 632-1727
CITY:OAKLANDSTATE: CAZIP CODE:
94603
CAPACITY: 14TOTAL ENROLLED CHILDREN: 16CENSUS: 7DATE:
07/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:23 AM
MET WITH:Tammie Russell-JonesTIME COMPLETED:
02:10 PM
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On 7/17/23 at 11:23 am, Licensing Program Manager (LPM) Loretta Dyson and Licensing Program Analyst (LPA) Randall Dunevant arrived at the home for an unannounced Required Inspection. LPM and LPA met with Tammie Russell-Jones. There was 1 infant, 4 preschool age children, and 2 school age children also present. The hours of operation are 4:30am-1am, Monday-Friday.

LPM and LPA toured the areas of the home used to provide care for children, to complete a health and safety inspection. LPM and LPA observed that the home is neat and clean, with heating and ventilation for the safety and comfort of children in care. The home is a two story home. The upper level of the home consists of the living room, dining room, kitchen, television room next to the kitchen, two bedrooms next to the living room and one bathroom. The lower level of the home consists of an office, exercise room, lounge room, bathroom, laundry room and storage closets. There is a detached garage and guest house in the backyard. The on limit areas consist of the living room, dining room, kitchen, two bedrooms and bathroom on the upper level. All other areas are off limits and made inaccessible by closed and/or locked doors and visual supervision. The isolation area will be a section of living room or dining room, away from other children in care. The outdoor play area is fully fenced and the licensee stated that children are limited to the front left side of the yard for play. LPM and LPA observed all of the children's toys in this area. LPM and LPA observed that other parts of outdoor area are not blocked off or separated, but are free of dangerous items. The licensee stated that the guest house is only used when someone is visiting and is otherwise used for storage.

LPM and LPA observed an ample supply of age appropriate toys and activities, which were in good condition and free of defects. LPM and LPA did not observe any bodies of water, medications, cleaning supplies or hazardous items accessible to children today. The home is equipped with a working combination smoke and carbon monoxide detector, fully charged 2A10BC fire extinguisher, working telephone, and first aid kit. The licensee and one assistant need to renew the mandated reporter training.
SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2023
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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Document Has Been Signed on 07/17/2023 02:01 PM - It Cannot Be Edited


Created By: Loretta Dyson On 07/17/2023 at 01:28 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: RUSSELL-JONES, TAMMIE
FACILITY NUMBER: 013416181

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)


This requirement is not met as evidenced by:
The family day care home shall maintain documentation of the required immunizations or exemptions from immuniztion, as set forth in this section, in the person's personnel record that is maintained by the family day care home.
Deficient Practice Statement
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Based on review of two assistant files, which do not have proof of measles (MMR) immunization. Proof of immunization for influenza or a statement declining the flu shot is needed for all staff. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/17/2023
Plan of Correction
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The licensee agrees to obtain proof of immunization for measles (MMR) and proof of current flu shot or a statement declining the flu shot for the two assistants providing care during today's inspection.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Diane Perez
LICENSING EVALUATOR NAME:Loretta Dyson
LICENSING EVALUATOR SIGNATURE:
DATE: 07/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/17/2023


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: RUSSELL-JONES, TAMMIE
FACILITY NUMBER: 013416181
VISIT DATE: 07/17/2023
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The licensee stated that there are no firearms in the home. The licensee conducted a fire/disaster drill in February 2023. LPM and LPA reviewed 3 children’s files, and found that 1 child's file did not have proof of immunizations. The two assistant files reviewed did not have proof of immunization for measles. LPM and LPA did not observe any walkers, baby bouncers, drop down cribs or other equipment is not allowed in day care facilities.

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. Licensee 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.

LPA discussed the safe sleep regulations with licensee 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 [or facility representative] 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 22-02CCP. 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 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.

SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023
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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: RUSSELL-JONES, TAMMIE
FACILITY NUMBER: 013416181
VISIT DATE: 07/17/2023
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During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA Dunevant completed the RSO profile in FAS on 7/11/23.

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

See 809D for deficiency being cited today.

Exit interview conducted and report was reviewed with the licensee, Tammie Russell-Jones.

SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023
LIC809 (FAS) - (06/04)
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