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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423537
Report Date: 06/22/2021
Date Signed: 06/22/2021 11:46:12 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 06/22/2021 11:46 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:BEY, KAAMILFACILITY NUMBER:
013423537
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 11DATE:
06/22/2021
TYPE OF VISIT:Required - 1 YearANNOUNCEDTIME BEGAN:
09:24 AM
MET WITH:Kaamil BeyTIME COMPLETED:
12:00 PM
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On June 22, 2021 at 9:24AM, Licensing Program Analyst (LPA) Catherine Fernandes conducted an announced Annual Required Inspection in conjunction with an increase in capacity inspection with Licensee Kaamil Bey. Residing in the home is the Licensee, her finger print cleared husband and two underage children. Present during the inspection were her husband, four finger print cleared staff, three infants and seven preschoolers in care. LPA and Licensee did a walk through of the home to conduct a health and safety inspection. Operating hours will be 8:00AM to 5:30PM, Monday through Friday.

The house is a four level home that consists of five bedrooms and three and half bathrooms. The OFF LIMIT AREAS are the kitchen (main floor), the garage (top floor), the three bedrooms, two bathrooms and the deck (on the second floor), the office and the den (first floor), which will be inaccessible by closed and/or locked doors or visual supervision. The ON LIMIT AREAS are the living room/dining room combo which is the main area of the day care, the half bathroom, the two bedrooms, the full bathroom in the one of the bedrooms, the deck right off the the living room and the fenced in front yard area. The ISOLATION AREA will be the bedroom with the sliding door that leads to the front yard. Outdoor play area will be in the fenced in front yard and the back patio area. There are toys and play equipment for the children. There are no pools, hot tubs or any other bodies of water during today's inspection.

The home has a fully charged 3A40BC fire extinguisher that was last serviced on 2/2021 and pull down fire alarm on the wall next to the front door and a working smoke/carbon monoxide detector in the main area of the day care. Licensee has a working telephone and complete First Aid Kit. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 4/2/2021. The Licensee's CPR and First Aid certificate is current and expires on 6/21/2023. There is a fire place in the living room that is covered to prevent access by children. Per Licensee, there are no firearms in the home. The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required training for
REPORT CONTINUES ON LIC 809C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2021
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: BEY, KAAMIL
FACILITY NUMBER: 013423537
VISIT DATE: 06/22/2021
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child care providers, which has been completed on 06/18/2021. The licensee has provided proof of the Lead Safety training for Child Care Providers which will be completed on 07/13/2021. Five of the five children's files were reviewed, along with two staff members.
On 06/07/21, a fire clearance was granted to facility by the Oakland Fire Department. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

Incidental Medical Services (IMS) policy was discussed and Licensee is providing IMS as of today.

COVID-19 postings were posted during todays inspection.

The Licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident.



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 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

As of 6/22/2021, this home is recommended for an increase of capacity.

There are no deficiencies cited today.
The report will remain on file for three years.
An exit interview was conducted with Licensee.
Report, Appeal Right and Notice of site visit was provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021
LIC809 (FAS) - (06/04)
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