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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409256
Report Date: 02/02/2024
Date Signed: 02/02/2024 11:25:33 AM

Document Has Been Signed on 02/02/2024 11:25 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ORELLANA, FANYFACILITY NUMBER:
073409256
ADMINISTRATOR:ORELLANA, FANYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 713-2152
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 11DATE:
02/02/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Fany OrellanaTIME COMPLETED:
12:00 PM
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On 2/2/24 Licensing Program Analysts (LPAs) Monica Mathur and Dealia Frison conducted an Unannounced Required Inspection at Fany Orellana's Family Child Care Home. LPAs met with Licensee, Fany and explained the purpose of today’s inspection. Present in the home were Licensee, Assistant/Daughter, spouse and 11 day care children (preschool age). Facility is in compliance with required ratios today. Licensee was reminded when no Assistant is present at a Large Family Childcare Home, they shall comply with the capacity requirements for a Small Family Childcare Home. Adults present in the home have Criminal Background Check Clearances.

Indoor Space was inspected. LPAs observed sufficient materials, toys, and play equipment. Children were engaged in various activities under the supervision of the Licensee and Assistant. All detergents, cleaning compounds, medications, and other similar items were inaccessible to children. Furniture and equipment were age appropriate and in good condition. There were no baby walkers, jumpers or bouncers observed during inspection. The home is sanitary, orderly and safe. LPAs observed a fully charged fire extinguisher that meets State Fire Marshal standards and working smoke/carbon monoxide detectors. There is a small fish tank on the kitchen counter and made inaccessible to children. Last fire/disaster drill was completed 10/10/23. All required postings were observed posted on a wall. Snacks/meals are provided and food storage area was observed to be sanitary.
In Use Areas: Living room, Hallway Bathroom, Bedroom #1 (first room on left side of hall) Off Limit Areas: Kitchen, Bedrooms #2, #3, Master Bathroom, Garage/Den, Den Bathroom.
Outdoor Space was inspected. Licensee stated during recent rain storm, their storage shed was destroyed and they had to install a temporary shed in the right portion of backyard. Licensee reported the incident to Licensing in a timely manner. During today's inspection, LPAs made observations.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2024
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ORELLANA, FANY
FACILITY NUMBER: 073409256
VISIT DATE: 02/02/2024
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Children will not be using the backyard for the time being until a gate/fence is installed cordoning the right side. Licensee will inform once the new shed is constructed. Play equipment on the left portion of yard was observed in safe condition and free of hazards. Heavy structure was secured to the ground. The yard was fenced and there were no bodies of water observed.
Off Limit Areas (temporary): Right half portion on yard
File Review: Sample of children files taken had required documents, Licensee’s Mandated Reporter Training is current (expires 10/5/24) and CPR/First Aid is current (expires 7/22/25).

Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

On 2/2/24 California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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 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.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ORELLANA, FANY
FACILITY NUMBER: 073409256
VISIT DATE: 02/02/2024
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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, and reviewed children’s, personnel, and administrative records. 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/.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

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

In the areas that were evaluated, no regulatory violations were observed.
Exit interview conducted and report was reviewed with the Licensee, Fany Orellana. During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
A Notice of Site Visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024
LIC809 (FAS) - (06/04)
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