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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417539
Report Date: 03/23/2022
Date Signed: 03/24/2022 09:04:49 AM

Document Has Been Signed on 03/24/2022 09:04 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:HAMILTON, VALERIE & ANTHONYFACILITY NUMBER:
013417539
ADMINISTRATOR:HAMILTON, VALERIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 638-6222
CITY:OAKLANDSTATE: CAZIP CODE:
94621
CAPACITY: 14TOTAL ENROLLED CHILDREN: 1CENSUS: 1DATE:
03/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Valerie HamiltonTIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Diana Campos arrived at 1:30 PM for an unannounced 1 year required Inspection, and met with Licensee Valerie Hamilton. Present for this inspection was one child in care. No other adults were present during today's inspection. The on limits areas of the home were toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 5:00am to 7:00pm.

ON LIMITS: Living room, dining room, hallway, hallway bathroom and back yard.
OFF LIMITS: Both bedrooms at the end of the hallway, kitchen, bedroom behind the kitchen, the detached garage. Off limit areas are inaccessible by closed and/or locked doors and visual supervision at all times.

The home is single story, with heating and ventilation for safety and comfort. The outdoor play area is the fenced back patio. Licensee was reminded to notify licensing prior to changing an off limits area to an on limits area. There were ample age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. There is a fully charged 3A40BC fire extinguisher, working carbon monoxide and smoke detectors, telephone, and first aid kit. The fireplace is blocked to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 03/19/2022. All required licensing documents are posted and visible for public review. At 2:00pm children and facility files were reviewed and found to be complete. The facility roster was reviewed, and a copy obtained. The licensee is in ratio today. Licensee provided a copy of day care insurance. The licensee's Pediatric CPR/First Aid certificate is current and expires 10/17/2023. Licensee has proof of the required immunizations, and mandated reporter training was completed on 01/30/2022.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2022
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: HAMILTON, VALERIE & ANTHONY
FACILITY NUMBER: 013417539
VISIT DATE: 03/23/2022
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/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-and-resources/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.

No deficiencies cited today.

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

Exit interview conducted and report was reviewed with the licensee Valerie Hamilton.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2022
LIC809 (FAS) - (06/04)
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