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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417539
Report Date: 06/27/2025
Date Signed: 06/27/2025 01:53:27 PM

Document Has Been Signed on 06/27/2025 01:53 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:HAMILTON, VALERIE & ANTHONYFACILITY NUMBER:
013417539
ADMINISTRATOR/
DIRECTOR:		HAMILTON, VALERIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 638-6222
CITY:OAKLANDSTATE: CAZIP CODE:
94621
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 4DATE:
06/27/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Valerie Hamilton, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:06 PM
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Licensing Program Analysts (LPAs) Canela and Merchant arrived unannounced on 06/27/2025 at this Large Family Child Care Home facility for the purpose of conducting a Required – 3 Year annual inspection. Upon arrival LPAs were greeted by Licensee Valerie Hamilton. Licensee stated there are a total of 6 children currently enrolled at the facility. Present during today’s inspection were four children, two pre-school age and two school-age.

Facility hours of operation are Monday – Friday from 7:30 am to 5:30 pm.

Licensee Valerie Hamilton stated ex-spouse Anthony Hamilton no longer has residence at this facility. LPAs advised for Licensee to contact their ex-spouse and submit a statement in writing of their intent to be removed from the facility. Licensee Valerie to submit ex-spouse's statement and a new application (with paid fee) to Community Care Licensing to remove ex-spouse from the License.

This is a one story home which consists of 3 bedrooms, 2 1/2 bathrooms, kitchen, dining room, living room, laundry room, attached garage, and backyard.

On-limit areas (accessible to children): Living room (located at front entrance), hallway bathroom, and dining room area (located adjacent to living room). Applicant will be utilizing the living room as the main room for her day care area.

Off-limit areas (inaccessible to children): Kitchen, laundry room, den, two bedrooms, backyard, and attached garage.

                                  Report continued on LIC 809-C
NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Karina Canela
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 9
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: HAMILTON, VALERIE & ANTHONY
FACILITY NUMBER: 013417539
VISIT DATE: 06/27/2025
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                                        Page 2 of 4
Physical Inspection:

The LPAs toured on-limit areas accessible to children. LPAs observed toys, play equipment and materials for children. Licensee stated there are no weapons or firearms in the home. There is a fully charged 3A40BC fire extinguisher. Smoke and carbon monoxide detectors were tested and observed operational. LPA observed a fireplace in the living room, which was screened and made inaccessible to children. Disaster Drill was conducted on 06/11/2025 and Fire Drill was conducted on 06/04/2025. Licensee stated the facility does not have a pool on the premises. LPAs did not observed any bodies of water. Licensee understands that when outside of facility, 100% supervision of children in care is required. Facility does not provide transportation for children; Licensee understands children cannot be left unattended in parked vehicles. Licensee does not provide overnight care. Licensee provides care for infants 24 months and under. Licensee stated they currently do not have any infants enrolled. There is a working telephone on the premises. Licensee understands smoking is prohibited on the premises.

Record Review:

Licensee Valerie Hamilton has current Adult and Pediatric First Aid/CPR/AED which expires 12/02/2025. Staff and children’s records were reviewed. Licensee has current Mandated Reporter Training which expires Jan/2026. The facility roster was reviewed and a copy was obtained. Required postings were observed near the entrance.

LPA reminded licensee day care needs to be operated within the limitations and capacity of a Large family Child Care Home with regard to ratios and Licensee is required to be present in the day care for 80% of the operation hours.

The facility provides Incidental Medical Services – IMS. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.


Report continued on LIC 809-C
NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Karina Canela
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: HAMILTON, VALERIE & ANTHONY
FACILITY NUMBER: 013417539
VISIT DATE: 06/27/2025
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                                            Page 3 of 4
LPAs discussed the following with Licensee Valerie Hamilton:

Safe Sleep Regulations were discussed. Child Care Licensing Safe Sleep webpage provided: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep

Recalled Infant Devices can be checked on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ Licensee was informed to register all infant devices with the CPSC to ensure notification of any recalls on purchased equipment.

Mandated Reporter Training: Any person who works in a child care facility shall complete and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

Criminal Record Clearance or Exemption: Licensee Valerie Hamilton understands all adults 18 and over residing, living in, 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 per day, per individual, for a maximum of 5 days will be assessed for violation of regulation for uncleared individuals residing or being present in the facility.

MyChildCarePlan.org – Centers and Family Child Care Homes: Website was provided for Licensee; a consumer education website which helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Megan’s Law – Family Child Care Homes. Licensee Valerie Hamilton confirmed there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

                                  Report continued on LIC809-C...
NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Karina Canela
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/27/2025 01:53 PM - It Cannot Be Edited


Created By: Karina Canela On 06/27/2025 at 12:20 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: HAMILTON, VALERIE & ANTHONY
FACILITY NUMBER: 013417539

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above due to a plastic box containing 6 bottles of prescribed medication observed in dining room area accessible to children in care (photos taken), which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/28/2025
Plan of Correction
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Licensee immediately removed the box of prescribed medications from on-limit area in dining room and put placed in locked bedroom. Licensee to submit a statement in writing they understand the regulation and will be in future compliance to Community Care Licensing.
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.
Monica Mathur
NAME OF LICENSING PROGRAM MANAGER:
Karina Canela
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2025


LIC809 (FAS) - (06/04)
Page: 5 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: HAMILTON, VALERIE & ANTHONY
FACILITY NUMBER: 013417539
VISIT DATE: 06/27/2025
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                                          Page 4 of 4
The following deficiency was observed during today's inspection:

102417(g)(4) Operation of a Family Child Care Home Violation: LPA observed a plastic bin with 6 bottles of prescribed medication located in dining room, on-limit area accessible to children in care. Licensee immediately removed the medication and placed in locked bedroom. LPA observed the following items located in hallway bathroom on-limit area accessible to children with labels "keep out of reach of children"; 2 aerosol body sprays, 1 box of shower vapor tabs, 1 Lysol spray disinfectant, and 1 fluoride mouth wash (photos taken). Licensee immediately removed and placed out of reach of children.

Licensee received LIC 9102 Technical Violations for the following regulations: 102419(d)(1), 102417(m)(3), 102417(b)


Deficiencies cited (see LIC809-D page) from the California Code of Regulations, Title 22, Division 12. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Appeal Rights Provided.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.

Exit interview conducted with the Valerie Hamilton, Licensee, whose signature confirms receipt. A notice of site visit was given and must remain posted for 30 consecutive days.

NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Karina Canela
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
LIC809 (FAS) - (06/04)
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