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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421865
Report Date: 06/06/2024
Date Signed: 06/06/2024 10:17:10 AM

Document Has Been Signed on 06/06/2024 10:17 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:AYCHILUHIM, TEGESTFACILITY NUMBER:
013421865
ADMINISTRATOR/
DIRECTOR:		AYCHILUHIM, TEGESTFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 200-1956
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
06/06/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Tegest AychiluhimTIME VISIT/
INSPECTION COMPLETED:
10:20 AM
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On June 6, 2024, at 8:00 AM, Licensing Program Analyst (LPA) Elimika Woods met with licensee Tegest Aychiluhim for an Unannounced Annual/Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during the inspection was the licensee's two fingerprint cleared assistants, and 11 preschool age children. The licensee stated that the facility operates from Monday to Friday 7:30 AM to 5:30 PM.

LPA toured the facility inside and out to conduct a Health and Safety inspection. This two-story home consists of five bedrooms, three baths, a living and dining room, kitchen, front-yard, office, backyard and two car detached garage. This home was clean and orderly, with (centralized) heating and ventilation for the safety and comfort of children. The Isolation area of the home will be a section of the childcare room, away from other children in care.

The off-limits will be made inaccessible by closed and/or locked doors and visual supervision. There's a gate/barrier at the bottom of the stairs in the front yard to prevent children five years or younger access to the upper floor. LPA checked the cabinets in the kitchen, bathrooms, on-limits bedrooms, and any other cabinets or drawers accessible to children in care and did not observe any hazardous materials or toxins accessible to children during today’s inspection.

On- Limit areas are the: Childcare room, napping bedroom, two downstairs bathrooms, kitchen, fully fence front and backyard area

Off- Limit areas are the: The main living quarters of the home (right side) separate from the main day-care rooms and the garage.

LPA tested the dual smoke and the carbon monoxide detector in the hallway and found it to be functioning properly, phone service, first aid kit that she keeps in the kitchen, and a fully charged 3A40BC fire extinguisher which meets standards established by the State Fire Marshal hanging on the kitchen wall. Around 8:30 AM, LPA inspected the front and backyard area to make sure that there are no pools, hot tubs or any other bodies of water present in the on-limit areas that violates any child care regulations during today's inspection and there was none.

See 809-C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE: DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: AYCHILUHIM, TEGEST
FACILITY NUMBER: 013421865
VISIT DATE: 06/06/2024
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LPA asked the licensee does she transports children and the licensee stated that she does not transport children. During the record review, LPA Woods checked the Health Records of the licensee, staff, and children and found that the licensee is following the immunization laws which pertain to all childcare providers. Per licensee, there are no firearms in the home. All required forms are posted and visible for public review.

The OUTDOOR PLAY area is the fully fenced front and backyard and LPA observed that it is free from defects or dangerous conditions. During today's inspection, LPA observed a large play structure with swings that’s anchored to the ground with cushioning underneath to absorb children falls in the backyard and a large pirate ship with a slide that also has cushioning underneath to absorb children's falls. There are ample age-appropriate toys that appear to be safe and in good condition. The licensee also has an enclosed trampoline in the frontyard area. LPA advised the licensee that she must comply with the manufacturer instructions listed on the trampoline, including supervision requirements, if any of the day care children use the trampoline.



At 9:00 AM, LPA requested and reviewed the files of two (2) children in care and two (2) staff files. All children’s files contain Immunization, Identification & Emergency Information, Parent's Rights, and Medical Consent forms and the staff files has the required Employee Rights and Health Screening forms. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 05/01/2024. The licensee has completed mandated reporter training on 03/17/2023. The licensee is in ratio today.

Effective August 1, 2003, California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

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/.



See 809-C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024
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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: AYCHILUHIM, TEGEST
FACILITY NUMBER: 013421865
VISIT DATE: 06/06/2024
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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 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.

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.

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.

The licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Tegest Aychiluhim, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There are 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 Tegest Aychiluhim.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3