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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700070
Report Date: 05/12/2021
Date Signed: 05/12/2021 11:58:46 AM

Document Has Been Signed on 05/12/2021 11:58 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:MACADAAN, JENNIFERFACILITY NUMBER:
015700070
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
05/12/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Jennifer Macadaan- LicenseeTIME COMPLETED:
12:10 PM
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On 5/12/21 at 11:35am, Licensing Program Analyst (LPA) Briana Plumboy conducted an unannounced Case Management Inspection with Licensee Jennifer Macadaan. Present for the inspection was 5 preschool age children in care as well as licensee's fingerprint clear and associated mother Erlinda Abrigo, licensee's fingerprint clear and associated son Joshua Macadaan, and licensee's partner Oscar Batres. The home was toured by LPA Plumboy along with the licensee. Hours of operation for day care are Monday through Friday, 6:00am until 6:00pm.

The home is two stories. The home consists of 3 bedrooms, 1 master bedroom/bathroom, 2 hallway bathrooms, a living room/dining room combo, garage, a kitchen, and a foyer. The home is clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the foyer, kitchen, garage, and entire second story of the home which will be inaccessible by closed and/or locked doors and visual supervision. There is a child safety gate located at the base of the stairs to prevent access to children under the age of 5 years old. The children enter the home through the foyer, walk through the kitchen, and then enter into the childcare area. When the children walk through the foyer and kitchen they must be supervised at all times. There is a child safety gate located between the kitchen and dining room/living room combo. The ON LIMIT AREAS are the living/dining room combo, downstairs bathroom, the downstairs bedroom located next to the bathroom, and backyard section 1 which is located down 2 steps off the living room. The ISOLATION AREA will be a couch in the dining room. Outdoor play area will be in the fenced backyard. The outdoor play area has 2 sections. The section the children play in is backyard 1 which is located down 2 steps off the living room, and backyard 2 is off limits to children in care and located behind the fence.

See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 05/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2021
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: MACADAAN, JENNIFER
FACILITY NUMBER: 015700070
VISIT DATE: 05/12/2021
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There is a 3A40BC fire extinguisher, carbon monoxide detector, pull down fire alarm, and smoke detector which meet State Fire Marshall standards during today's inspection.
Per licensee, there are no firearms in the home. There are no pets in the home. All required licensing documents are posted and visible for public review. The licensee's Pediatric CPR/First Aid certificate is current and expires 12/14/21. Licensee's mandated reporter training was completed on 12/27/19. Licensee is in compliance with the immunization law.

On 05/04/21, a fire clearance was granted to facility #015700070 by Alameda County Fire Department. Per the fire clearance, the 2nd story of the home and garage are off limit to children in care. All documents have been received 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.

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. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov .

As of 05/12/21, this home is recommended for an increase of capacity. There are no deficiencies cited today. The report will remain on file for three years. A notice of site visit was provided, and the licensee was reminded to have it posted for 30 days. This entire report has been read to the Licensee by LPA Plumboy. The licensee is aware the signature on this report confirm receipt of these documents. LPA asked the licensee if the licensee had any questions pertaining to any aspects including, but not limited to, any part of this report and of the documents given to the licensee, and per licensee, there are no further questions at this time. Licensee is aware at anytime she can reach out to LPA Plumboy or CCLD. An exit interview was conducted, and appeal rights provided.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2021
LIC809 (FAS) - (06/04)
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