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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422091
Report Date: 12/19/2022
Date Signed: 12/19/2022 01:20:14 PM

Document Has Been Signed on 12/19/2022 01:20 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:CABANILLAS-REZENDE, PATRICIAFACILITY NUMBER:
013422091
ADMINISTRATOR:CABANILLAS-REZENDE, PATFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 375-7401
CITY:OAKLANDSTATE: CAZIP CODE:
94609
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
12/19/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Patricia Cabanillas-RezendeTIME COMPLETED:
01:30 PM
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On December 19, 2022, at 11:40AM, Licensing Program Analyst (LPA) Indira Loza arrived announced on a case management inspection to place the facility from Inactive status to Active status. LPA Loza met with Licensee Patricia Cabanilla-Rezende. Only the Licensee was present for the inspection. Living in the home is the Licensee and her pet dog. There are no children in care during todays inspection. The purpose of the inspection was to put the home on active status and to conduct a health and safety check. Operating hours will be 7am-5:15pm Monday through Friday.

The home is a two story home. There is an upstairs and downstairs unit with a large backyard. The Licensee will be utilizing both floors for the daycare. The upstairs unit consists of a living room, dining room, two bedrooms, a kitchen, an office, and a small nook to left of the kitchen. The bottom unit consists of a bedroom, kitchen, living room, family room, bathroom, and a laundry room. The on limit areas on the top floor are both bedrooms, the bedroom directly to the right of the dining room will be the older children's nap room, and the bedroom on the right from the living room will be used as the nap room for the infants. The Living Room, Dining Room, and bathroom are also on limits. The On Limit Areas for the bottom unit are the bathroom for the older children, the entry way for the younger children to use their potty chairs, and the laundry room for the children to wash their hands. The bottom unit will only be used during outside play. The Off Limit areas on the top floor are the office and the nook to the left of the kitchen, and the kitchen. The Off Limit areas for the bottom floor are the kitchen, living room, family room, and the bedroom. The backyard is large and fully fenced. The backyard will be used for outdoor play. There is plenty of shade for the children, and an amply supply of age appropriate toys. LPA observed three lemon trees in the backyard with very sharp thorns.

There is a working carbon monoxide detector and a working smoke detector. The home is equipped with a pull down alarm system. The Licensee has a current CPR/First Aid certificate which expires on March 2024.
*****************************************Report Continues on 809-C*****************************************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2022
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: CABANILLAS-REZENDE, PATRICIA
FACILITY NUMBER: 013422091
VISIT DATE: 12/19/2022
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The Licensee also has a current Mandated Reporter Certificate which expires on September 7, 2024. There are age appropriate toys that are observed to be safe, clean and in good repair. There are no bodies of water or pools accessible to children in care during today’s inspection. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. There's a fireplace in the dining room that is blocked to prevent children access. Per Licensee, there are no firearms in the home. The home has a fully charged 2A10BC fire extinguisher. The Licensee will be providing food and snacks to the children in care. LPA reviewed the Safe Sleep Regulations with the licensee.

Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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 Provider Information Notifications for updated regulations. The Licensee was also reminded that Mandated Reporter Training is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com. CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.

Roster of the children must be properly maintained and fire/disaster drill every six months must be documented. Licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. LPA discussed the safe sleep regulations with the 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 applicants 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 *************************************Report Continues on 809-C*******************************************

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

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
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: CABANILLAS-REZENDE, PATRICIA
FACILITY NUMBER: 013422091
VISIT DATE: 12/19/2022
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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, 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.

Before the License can be turned to Active status the following needs to be completed by 1/20/23:


- Cover/Blockade for the lemon trees
- A gate to prevent access to the kitchen

Exit interview conducted with Licensee Cabanillas-Rezende
Report, notice of site visit, and Appeal rights provided to the Licensee.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
LIC809 (FAS) - (06/04)
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