073409267-4-4-2024-02-CC-CWAS-D3ZRJG-20240404130356

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409267
Report Date: 04/04/2024
Date Signed: 04/04/2024 01:04:01 PM

Document Has Been Signed on 04/04/2024 01:04 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	ANZASTIGA, BRENDA		FACILITY NUMBER:	073409267
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 4	CENSUS: 4	DATE:	04/04/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Brenda Anazastiga		TIME VISIT/ INSPECTION COMPLETED:	01:05 PM

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On 04/04/2024 at 9:15 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced case management – licensee initiated for Brenda Anzastiga's small family child care home. Licensee requested to be placed back on active status. LPA met with licensee and guided analyst on a tour of the facility. During today's inspection, there were 4 children in care (4 preschool aged children and 1 infant) and 4 children enrolled. Also present during inspection were licensee's husband and licensee's 15 year old child. Family members residing in the home are licensee, licensee husband, licensee's 2 minor children ages 15 and 9 years old. Licensee and all adults in the home have Criminal Record Clearance. Facility hours of operations are Monday - Friday from 6:00 AM - 6:00 PM.

Licensee completed her Pediatric CPR/First Aid certificate which expired 01/2026 and Mandated Reporter certificate which expires 05/2024. Licensee was reminded to complete her Mandated Report Training as it's a requirement. Licensee stated she will complete Mandated Reporter Training this weekend. Licensee has documentation maintained for Measles, Pertussis Immunization's, Influenza Opt-Out statement for the current flu season. The licensee provided proof of control of property. There is a working telephone in the home.

This is a two story home which consists of 4 bedrooms, 3 bathrooms, kitchen, dining room, family room, living room, upstairs loft, downstairs office, attached garage, and backyard.
The children on limits areas: Family Room, Living Room, Downstairs Office, Kitchen, Dining Room, First Floor Bathroom and backyard. Licensee will be utilizing the family room as the main room for her day care area.
Areas off limits include: 3 upstairs bedroom which includes the master bedroom, 2 bathrooms, downstairs bedroom, upstairs loft, laundry room, and attached garage.
The LPA toured all areas used by children during this visit.

*CON'T ON PAGE 2*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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: ANZASTIGA, BRENDA	FACILITY NUMBER: 073409267
	VISIT DATE: 04/04/2024

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*PAGE 2*

Per licensee, there are no firearm in the home. LPA observed an screened fireplace with a lock in the living room. LPA observed a fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detector. Medicines, cleaning products, sharp objects are stored inaccessible to children. LPA reminded licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. There are stairs in the home that are made inaccessible to children in care.

OUTDOOR SPACE: LPA toured the outdoor area and observed a fully fenced and safe backyard for children in care. LPA observed a play structure for children and age appropriate toys for children to play with. LPA did not observe any bodies of water. LPA reminded licensee when outside of facility, 100% supervision of children in care is required. Facility does not provide transportation for children, but licensee understands that children cannot be left alone, unattended in parked vehicles

LPA discussed and reminded Applicant day care needs to be operated within the limitations and capacity of a Small Family Child Care Home with regards to ratios and that Licensee has to be present in the day care for 80% of the operation hours.

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.

LPA provided the main office number for the Oakland Regional Child Care office (510) 622-2602. Licensee are to call and report injuries or unusual incidents within 24 hours of knowledge of occurrence. Licensees are to review the form (LIC 624B) to follow up in writing within 7 days of the injury/unusual incident.

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. *CON'T ON PAGE 3*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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: ANZASTIGA, BRENDA	FACILITY NUMBER: 073409267
	VISIT DATE: 04/04/2024

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*PAGE 3*

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

Effective as of 04/04/2024, licensee has been placed back on active status.

During today's inspection, there were no violation observed.

Exit interview conducted and report was reviewed with the licensee, Brenda Anzastiga. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

LIC809 (FAS) - (06/04)

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