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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417870
Report Date: 07/18/2023
Date Signed: 07/18/2023 04:01:39 PM

Document Has Been Signed on 07/18/2023 04:01 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:THOMPSON-HAMILTON, KEISHNAFACILITY NUMBER:
013417870
ADMINISTRATOR:THOMPSON-HAMILTON, KEISHNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 635-6884
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
07/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:23 PM
MET WITH:Keishna Thompson-HamiltonTIME COMPLETED:
04:10 PM
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On July 18, 2023 at 2:23pm Licensing Program Analyst (LPA) Indira Loza met with the Licensee Keisna Thompson-Hamilton for the purpose of conducting an unannounced 1-year annual inspection. Present for today’s inspection were the Licensee, the Licensee's Assistant, 11 preschool age children, and the Licensee's fingerprint cleared adult daughter. The facility is in ratio today. Hours of operation are 24 hours Monday - Friday.
The facility is a single-story home with four bedrooms; two bathrooms; living room; dining room; kitchen; and backyard.

ON LIMIT AREAS: Living Room, Dining Room, bathroom at the end of the hallway and the bedroom at the opposite end of the hallway, and the backyard.

OFF LIMIT AREAS: The bedroom directly in front of the hallway entrance, and the two bedrooms adjacent to the kitchen. The off-limit areas will be inaccessible by child gates, closed and/or locked doors and adult supervision.

ISOLATION AREA is in the living room.

The home has heating and ventilation for safety and comfort. The home has a fully charged 3A40BC fire extinguisher next to the kitchen. There was a working smoke detector, carbon monoxide detector, and a working telephone. Fire drills are conducted at least once every 6 months, the last drill was completed on June 16, 2023. Licensee has ample age-appropriate toys and learning materials inside and outside the home. Toxins, medicines, and hazardous items were inaccessible during today's inspection. The Licensee utilizes her backyard for outdoor play. LPA reviewed children's and Licensee's files which were found to be complete. The facility roster was reviewed, and a copy obtained. The Licensee had a current Mandated Reporter certificate which expires January 31, 2025, and CPR expires January 30, 2025. There is a blocked fireplace in the home to prevent access by the children. Per the Licensee, there are no firearms in the home.

**********************************Report Continues on LIC 809-C*******************************

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: THOMPSON-HAMILTON, KEISHNA
FACILITY NUMBER: 013417870
VISIT DATE: 07/18/2023
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The Licensee provides Breakfast, Lunch, Dinner, and three snacks.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02. 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

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.

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/inspection-process.

There were no deficiencies issued during today's visit.

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


Exit interview conducted and report was reviewed with the Licensee Keishna Thompson-Hamilton.

Report and Appeal Rights were provided.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023
LIC809 (FAS) - (06/04)
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