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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423689
Report Date: 11/29/2023
Date Signed: 11/29/2023 11:55:19 AM

Document Has Been Signed on 11/29/2023 11:55 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:JAFFE, MARTINA & ALEXANDER-TANNER, ELIFACILITY NUMBER:
013423689
ADMINISTRATOR:JAFFE, MARTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 593-9843
CITY:EMERYVILLESTATE: CAZIP CODE:
94608
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 4DATE:
11/29/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Eli Alexander-TannerTIME COMPLETED:
12:00 PM
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On 11/29/23 at 10:35am, Licensing Program Analyst (LPA) Ashley Akinleye arrived at the home for an unannounced required 1-year annual inspection. LPA met with licensee Eli Alexander-Tanner. There were 2 infants and 2 preschool children in care during the inspection. This family childcare home operates Monday - Friday 8:30am-4:30pm. LPA verified that the licensee's phone number and email address on file are correct.

LPA toured the home with licensee Eli Alexander-Tanner, to conduct a health and safety inspection. The home is a single-story home, and consists of 3 bedrooms, 2 bathrooms, living room, kitchen, dining area, upper deck backyard and lower backyard. LPA observed that the home is neat and clean with heating and ventilation for the safety and comfort of children in care. The on-limit areas include side entrance to home, upper deck to backyard, lower backyard area, living room, dining area, 1 master bedroom, and 1 bathroom. The off-limit areas include 2 bedrooms, 1-bathroom, kitchen and front yard. These areas are made inaccessible by closed and/or locked doors, gates, and visual supervision. LPA observed locks on lower cabinets to prevent access by children. The master bedroom is used for isolation of sick children, away from other children in care. The back yard is used for outdoor play and the yard is fully fenced. LPA did not observe any hazards or dangerous conditions in the yard. LPA observed an ample supply of age-appropriate toys, equipment and activities available for children both indoors and outdoors and observed that they are in good condition. LPA did not observe any bodies of water, toxins, medications or hazardous items that would be accessible to children. The licensees stated that there are no firearms on the premises.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2023
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: JAFFE, MARTINA & ALEXANDER-TANNER, ELI
FACILITY NUMBER: 013423689
VISIT DATE: 11/29/2023
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The home is equipped with fully charged 3A40BC fire extinguisher, a working carbon monoxide detector, working smoke detector, and first aid kits/supplies. Both licensees have proof of current CPR/First aid certificates, which expire on 12/17/23. The last documented fire drill was conducted on 6/15/23. Both licensees have mandated reporter which expire 12/13/23. LPA observed all of the required forms posted. LPA reviewed children's files, staff files and obtained a copy of the current roster.

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.

Licensee Eli Alexander-Tanner 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 Eli Alexander-Tanner 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 [or facility representative] 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.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: JAFFE, MARTINA & ALEXANDER-TANNER, ELI
FACILITY NUMBER: 013423689
VISIT DATE: 11/29/2023
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LPA reminded the licensees that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. LPA provided the main office number for the Oakland Regional Child Care office (510) 622-2602 for the licensees to call and report injuries or unusual incidents and reviewed the form to follow up in writing within 7 days of the injury/unusual incident. The licensees were encouraged to periodically review regulations, guidelines and Provider Information Notices (PINs) on the website www.ccld.ca.gov.

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/.

Licensee Eli Alexander-Tanner 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 Eli Alexander-Tanner, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Licensee has current daycare liability insurance which expires on 3/8/24.

LPA reminded the licensee that the mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

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

Exit interview conducted. Appeal rights and report was reviewed with the licensee Eli Alexander-Tanner.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC809 (FAS) - (06/04)
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