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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700070
Report Date: 01/17/2023
Date Signed: 01/17/2023 11:31:18 AM

Document Has Been Signed on 01/17/2023 11:31 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:MACADAAN, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 520-5261
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
01/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jennifer Macadaan- LicenseeTIME COMPLETED:
11:40 AM
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On 1/17/23 at 10:00am, Licensing Program Analyst (LPA) Briana Plumboy conducted an unannounced Inspection with Licensee Jennifer Macadaan. Present for the inspection was 6 preschool age children in care as well as licensee's fingerprint clear and associated mother Erlinda Abrigo 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. The outside play area is enclosed with ventilation for the children to have fresh air and padding on the ground.

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. All required licensing documents are posted and visible for public review. The licensee's Pediatric CPR/First Aid certificate is current and expires 11/20/23 and assistant Oscar Batres' expires 06/23/23. Licensee's mandated reporter training was completed on 1/2/22 and Oscar Batres' was completed on 6/1/22. Licensee and assistants present are in compliance with the immunization law. The licensee conducts and documents fire and disaster drills at least twice a year with the last one conducted on 8/22/22. The facility has current daycare insurance. The licensee is in ratio today. See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: MACADAAN, JENNIFER
FACILITY NUMBER: 015700070
VISIT DATE: 01/17/2023
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Incidental Medical Services (IMS) policy was discussed. 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: http://www.ada.gov/childqanda.htm

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, 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

LPA discussed the safe sleep regulations with licensee Jennifer Macadaan 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 Jennifer Macadaan 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.

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Jennifer Macadaan.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2023
LIC809 (FAS) - (06/04)
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