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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408635
Report Date: 02/06/2025
Date Signed: 02/06/2025 04:27:58 PM

Document Has Been Signed on 02/06/2025 04:27 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:HINOJOSA, KARENFACILITY NUMBER:
073408635
ADMINISTRATOR/
DIRECTOR:		HINOJOSA, KAREMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 215-2568
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
02/06/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:38 PM
MET WITH:Karen HinojosaTIME VISIT/
INSPECTION COMPLETED:
04:40 PM
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On 02/06/2025 at 1PM, Licensing Program Analyst (LPA) Kareeca “Reeca” Sykes met with Licensee Karen Hinojosa for an Unannounced Annual/Random Inspection. Present during the inspection were the licensee, licensee's mother, and the licensee's assistant who is fingerprint cleared. There were eight (8) children in care during the inspection consisting of two (2) infants and six (6) preschoolers. Residing in the home are the Licensee, the licensee's spouse, the licensee's mother, the licensee's uncle (who are all fingerprint cleared) and the licensee's two minor children. Licensee’s home was toured for a health and safety inspection. The facility operates 7AM – 5:30PM Monday - Friday.

The home is a two story home that consists of four (4) bedrooms, two and a half (2 1/2) bathrooms, kitchen, dining room, living room, family room (converted into main day care area), garage, and backyard. The entrance to the day care is the front door. The inside and outside of the home were observed to be neat, clean with age-appropriate materials and toys for the children. Toxins, medications, and hazardous materials were observed to be in inaccessible areas during todays inspection. LPA observed the following precautions accessible cabinets and drawers in the kitchen have safety latches. The fire place is made inaccessible to children in care by closed and locked doors as well as 100% supervision per Licensee. Licensee stated there is one pet (cat) and there are no firearms in the home. LPA did not observe a body of water in or around home.

ON LIMITS AREA: Family Room (Converted to main Daycare area), Dining room, Kitchen, Living room, Half (1/2) bathroom (Located downstairs), and Backyard
OFF LIMITS AREA: Garage, The complete upstairs (Bedroom 1 -4 , Bathroom 1, Bathroom 2)

ISOLATION AREA: Table located next to the entrance away from other children in care
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SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Kareeca Sykes
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: HINOJOSA, KAREN
FACILITY NUMBER: 073408635
VISIT DATE: 02/06/2025
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The home has a fully charged 3A40BC fire extinguisher, a working smoke and carbon monoxide detector in the hallway and a working telephone, and all required forms are posted. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 11/24. Licensee's CPR and First Aid certificate is current and expires on 01/06/2026. The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required training for all people caring for children which was conducted on 11/28/2022 (expired).

File Review: Children sign in and out procedures and logs were reviewed. A sample of six (6) Children's files and one (1) Staff files was taken for review.

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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.
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SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Kareeca Sykes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: HINOJOSA, KAREN
FACILITY NUMBER: 073408635
VISIT DATE: 02/06/2025
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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 Karen Hinojosa, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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 following deficiency was observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was
reviewed with the Licensee Karen Report and Appeal rights were given to Licensee Karen Hinojosa.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Kareeca Sykes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/06/2025 04:27 PM - It Cannot Be Edited


Created By: Kareeca Sykes On 02/06/2025 at 03:05 PM
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: HINOJOSA, KAREN
FACILITY NUMBER: 073408635

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above when LPA observed two (2) infants sleeping in play yard/ crib with blankets on top of them which poses/posed a potential health, safety or personal rights risk to persons in care. Blankets were immediatly removed by licensee.
POC Due Date: 02/14/2025
Plan of Correction
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Licensee will submit a wirtten statement on how they understand this regulation and will prevent this incident from occuring again to LPA by COB 02/14/2025.
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above which licensee stated they do not document infants sleeping every 15 minutes which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2025
Plan of Correction
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Licensee stated they will began documeting infants sleeping every 15 minutes and submit form to LPA by COB 02/14/2025.
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:Sherelle Johnson
LICENSING EVALUATOR NAME:Kareeca Sykes
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2025


LIC809 (FAS) - (06/04)
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