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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700204
Report Date: 03/13/2025
Date Signed: 03/13/2025 10:58:45 AM

Document Has Been Signed on 03/13/2025 10:58 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ESCOBEDO, GRACIELAFACILITY NUMBER:
015700204
ADMINISTRATOR/
DIRECTOR:		ESCOBEDO, GRACIELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 750-6918
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
03/13/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Graciela EscobedoTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On March 13, 2025, at 8:00 AM, Licensing Program Analyst (LPA) Elimika Woods met with licensee Graciela Escobedo for an Unannounced Annual/Random Inspection. LPA disclosed the purpose of the inspection and toured the facility inside and out to conduct a Health and Safety inspection. Present during the inspection were eight preschool age children, one school age child, and three infant children. Also present during the inspection was the licensee's two assistants. All adults subject to criminal background review have obtained criminal record clearance. The licensee stated that the facility operates from Monday to Friday 7:00 AM to 5:00 PM.

This one story home consists of four bedrooms, two baths, a living and dining room, kitchen, child care room, backyard and garage. This home was clean and orderly, with (centralized) heating and ventilation for the safety and comfort

At 8:15 AM, LPA inspected the backyard area to make sure that there are no pools, hot tubs or any other bodies of water present that violates the childcare licensing laws and there were none, during today's inspection. Per licensee there are no weapons of any kind in the home. The licensee is in ratio today.

On- Limit areas are the: Living and dining room, kitchen, child care room, nap room, front-yard, bedroom (2) and bathroom next to nap room.
The Isolation area of the home will be a section of the living room, away from other children in care.

Off- Limit areas are the: bedroom (1) next to bathroom, master bedroom and bath, laundry room, both side yards, side deck, and garage.
The off-limits are will be made inaccessible by closed and/or locked doors and visual supervision.

LPA tested the dual smoke and carbon monoxide detector in the child care room and found it to be functioning properly. The facility has a fully charged 2A10BC fire extinguisher which meets standards established by the State Fire Marshal hanging on the wall near the front door, a working telephone, and pull down fire alarm system. LPA checked the cabinets in the on limit areas which includes the living and dining room, kitchen, child care room, nap room, bedroom (2) and bathroom next to nap room and any other cabinets or drawers accessible to children in care and did not observe any hazardous materials or toxins.

See 809-C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ESCOBEDO, GRACIELA
FACILITY NUMBER: 015700204
VISIT DATE: 03/13/2025
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At 8:30 AM, LPA asked the licensee does she transports children and the licensee stated that she does not transport children. During the record review LPA Woods checked the Health Records of the licensee, staff, and children and found that the licensee is following the immunization laws which pertain to all childcare providers. All required forms are posted and visible for public review.

The front-yard play area is fully fenced and LPA observed that it is free from defects or dangerous conditions. There are ample age-appropriate toys that appear to be safe and in good condition. There's a swing set that's anchored to the ground with cushioning underneath to absorb children's falls. The backyard and both side-yards are off limits to children in care.

At 9:00 AM, LPA requested and reviewed the files of three (3) children in care and two staff files. All children’s were complete and contain Immunization Records, Identification & Emergency Information, Parent's Rights, and Medical Consent forms. The licensee did not conduct a fire and disaster drills within the required time frame of six months and LPA reminded her to conducted one immediately. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires on 08/2026. The licensee has not completed mandated reporter training renewal.

The following deficiencies were observed during today's inspection:
At 9:30 AM, LPA determined during the staff file review that S1 and the licensee did not complete their mandated reporter renewal.

Effective August 1, 2003, 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 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. The licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

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/.



See 809-C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ESCOBEDO, GRACIELA
FACILITY NUMBER: 015700204
VISIT DATE: 03/13/2025
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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-andresources/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.

Licensee 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.

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.

The licensee 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 Graciela Escobedo, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

See 809-D for deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Graciela Escobedo.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025
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Document Has Been Signed on 03/13/2025 10:58 AM - It Cannot Be Edited


Created By: Elimika Woods On 03/13/2025 at 10:30 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: ESCOBEDO, GRACIELA
FACILITY NUMBER: 015700204

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in which her and her assistant did not complete mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/27/2025
Plan of Correction
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Licensee will email or text her and her assistants completed Mandated Reporter certificate to LPA Woods by 03/27/2025 by the close of business.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Chandra Charles
LICENSING EVALUATOR NAME:Elimika Woods
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2025


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