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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422091
Report Date: 10/10/2024
Date Signed: 10/10/2024 11:06:43 AM

Document Has Been Signed on 10/10/2024 11:06 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CABANILLAS-REZENDE, PATRICIAFACILITY NUMBER:
013422091
ADMINISTRATOR/
DIRECTOR:		CABANILLAS-REZENDE, PATFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 375-7401
CITY:OAKLANDSTATE: CAZIP CODE:
94609
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 4DATE:
10/10/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Patricia Cabanillas-RezendeTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On 10/10/2024 at 8:15 AM Licensing Program Analyst (LPA), A. Curry arrived at the home and conducted an unannounced annual/random inspection. LPA met with licensee, Patricia Cabanillas-Rezende, who granted inspection authority to tour the facility. Also present for the inspection were licensee’s fingerprint cleared daughter, uncleared assistant, and 4 children in care, consisting of 1 infant and 3 preschoolers. During today's visit the licensee was aware her assistant, Clelia M. Souza, did not have an eligible criminal background clearance (See 809D). Licensee was advised that Clelia is not allowed to return to the facility until she has an eligible clearance. The licensee was also advised to check Guardian or contact the Oakland office to verify clearance. Licensee states there are currently 7 children enrolled. Children’s files were reviewed. Assistant did not have a complete file available to review (See 809D).

The children use the upstairs bathroom in the hallway, living room, dining area, bedroom located across from the dining room,first bedroom to the right of the living room, and backyard. During today's visit the LPA added the upstairs kitchen, downstairs playroom, and kitchen inside the play room as on-limit areas. The licensee was advised that any off- limit area that will be changed to an on limit area will need to be inspected by Licensing prior to use. The off-limits areas are the office, downstairs bathroom, and nook to the left of the upstairs kitchen, which will be inaccessible by closed and/or locked doors and visual supervision. The isolation area is in the living room. The LPA toured all areas used by children.



Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. There were no fireplaces or open face heaters accessible to children. There are safe toys, play equipment, and materials observed for children. There is a safety gate at the bottom of the stairs and an upstairs door to prevent children from accessing the stairs from the upper portion of the home. All poisons, cleaning solutions, medications, and other items that pose a danger to children are inaccessible during this visit. The home is equipped with a fully charged 2A10BC fire extinguisher and working dual smoke alarm/ carbon monoxide detector. Licensee states there are no firearms on the premises. There are no pools, spas, hot tubs, fishponds or similar bodies of water. Licensee does not have current CPR and First Aid training (See 809D). The licensee indicated she had an appointment scheduled, but the trainer cancelled last minute.
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: CABANILLAS-REZENDE, PATRICIA
FACILITY NUMBER: 013422091
VISIT DATE: 10/10/2024
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AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com


LPA observed and inspected sleeping equipment for infants. All equipment meets the US Consumer Product Safety Commission standards. LPA observed that cribs and/or play yards were free from loose articles and objects. There are no objects hanging above or attached to the side of the crib. Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months of age should be placed on their back for sleeping. The licensee was reminded that all infants up to 12 months of age shall have the LIC 9227 form placed in their file.

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.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/.
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024
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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: CABANILLAS-REZENDE, PATRICIA
FACILITY NUMBER: 013422091
VISIT DATE: 10/10/2024
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview the licensee, Patricia Cabanillas-Rezende, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted, appeal rights were given, and report was reviewed with the licensee, Patricia Cabanillas-Rezende.

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.

SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024
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Document Has Been Signed on 10/10/2024 11:06 AM - It Cannot Be Edited


Created By: Ashley Curry On 10/10/2024 at 10:04 AM
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: CABANILLAS-REZENDE, PATRICIA
FACILITY NUMBER: 013422091

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above by ensuring all staff have an eligible criminal background clearance prior to working in the facility, which poses/posed a potential health, safety or personal rights risk to persons in care. The licensee was advised that Clelia can not return to the facility until she has an eligible clearance. Licensee was asked to check Guardian or contact the Oakland office to verify clearance.
POC Due Date: 10/17/2024
Plan of Correction
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By 10/17/2024 email LPA livescan receipt.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

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 by ensuring all staff have required immunizations in their file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2024
Plan of Correction
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By 11/08/2024 email LPA proof of immunity to Measles, Pertussis, and T.B for Clelia.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Monica Mathur
LICENSING EVALUATOR NAME:Ashley Curry
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2024


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Document Has Been Signed on 10/10/2024 11:06 AM - It Cannot Be Edited


Created By: Ashley Curry On 10/10/2024 at 10:33 AM
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: CABANILLAS-REZENDE, PATRICIA
FACILITY NUMBER: 013422091

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)


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 by not ensuring at least one person who is at the facility during day care hours has a current CPR/First Aid certification, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2024
Plan of Correction
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By 11/08/2024 email LPA copy of an unexpired EMSA certified Pediatric CPR/First Aid card or confirmation of enrollment into an EMSA Pediatric CPR/FIrst Aid course.
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.
SUPERVISOR'S NAME:Monica Mathur
LICENSING EVALUATOR NAME:Ashley Curry
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2024


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