015700129-4-24-2023-52-CC-RHAR-CR7V55-20230424160721

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700129
Report Date: 04/24/2023
Date Signed: 04/24/2023 04:07:30 PM

Document Has Been Signed on 04/24/2023 04:07 PM - 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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	GIL, ANDREA		FACILITY NUMBER:	015700129
ADMINISTRATOR:	GIL, ANDREA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 699-8803
CITY:	SAN LEANDRO	STATE: CA	ZIP CODE:	94577
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 7	CENSUS: 6	DATE:	04/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:55 PM
MET WITH:	Andrea Gil		TIME COMPLETED:	04:15 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

On April 24, 2023 at approximately 1:55pm Licensing Program Analysts (LPA) Russ Haderer arrived unannounced to an annual inspection for health and safety. Present for the inspection was licensee Andrea Gil and 6 children in care (2 infants; 1 two-years old; 2 four-years old; 1 five-years old). The facility is in ratio today. The hours of operation remain at 8:00 am to 5:00pm.

The facility is a two-bedroom, one bath single family one-story home with front and back yard areas, and a detached one-car garage. There is a non-functioning fireplace in the living room that has a screen also blocked with a bookcase.

ISOLATION AREA will be in the living room on the couch away from other children in care until their parents can come and pick them up.

On-limit-areas include: Living room, dining room, kitchen; house bathroom and fenced front and backyard areas. Licensees reminded that other than wipes or things used for the children in the on limits bathroom, they need to be empty of most all items (or locked up) such as cleaning products etc. The kitchen has appropriate latches for safety mounted on all cupboards within children's reach, knives are stored in top cupboards out of the children’s reach. There were no hazardous items in any drawers or cupboards.

Off-limit-areas include: Both bedrooms of the house; and the detached garage. The off-limit areas will be inaccessible by closed and/or locked doors.

There is a fully charged 2A10BC fire extinguisher mounted on the wall near the washer and dryer. The facility has a working (tested) smoke and carbon monoxide detectors. Per licensee, there are firearms in the home locked up in a safe with ammunition is stored separately. The licensee conducts and documents Fire/Disaster Drills at least once every six months, the last drill was completed 4-21-2023. The licensee owns the property and carries liability insurance through Accord, policy is in force until August 1, 2023.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GIL, ANDREA	FACILITY NUMBER: 015700129
	VISIT DATE: 04/24/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The home is neat and clean, with heating and ventilation for safety and comfort. LPA did not observe any hazardous materials, or toxins accessible to children on the premises during the inspection. There were ample age appropriate toys inside and outside the home that were observed to be safe and in good condition. The outdoor play area is free from defects and dangerous conditions and has artificial turf in both yards.

Children's files were reviewed, the facility roster was reviewed and a copy obtained. All files were complete and in good order.

Licensee’s Pediatric CPR/First Aid certificate is current and expires 4-10-2024. Licensee’s Mandated reporter training was completed 2-28-2022. Licensee, and all adults living in the home are in compliance with immunization laws which pertains to day care providers. LPA reminded licensee that CPR/1^st Aid and Mandated Reporter training is to be renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GIL, ANDREA	FACILITY NUMBER: 015700129
	VISIT DATE: 04/24/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

There were no deficiencies issued today. This report will remain on file for three years.

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

Exit interview conducted and report was reviewed with the licensee Andrea Gil.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3