075700232-7-2-2021-52-CC-JPLA-C4JPVG-20210702113908

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 075700232
Report Date: 07/02/2021
Date Signed: 07/02/2021 11:39:21 AM

Document Has Been Signed on 07/02/2021 11:39 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SCHAEFER, MARNI		FACILITY NUMBER:	075700232
ADMINISTRATOR:	SCHAEFER, MARNI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 786-5671
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94583
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	07/02/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Marni Schaefer		TIME COMPLETED:	11:50 AM

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 July 2, 2021, at 9:05am, Licensing Program Analyst (LPA) Julia Placencia arrived for an announced prelicensing inspection, and met with the applicant Marni Schaefer. The home was toured with the applicant to conduct a health and safety inspection. Applicant states the hours of operation for daycare will be Monday through Friday, 8:00am to 5:00pm. The home is two story and consists of a kitchen, living room, two bedrooms, two bathrooms, laundry room, garage and a backyard. The home is neat and clean with heating and ventilation for safety and comfort. ON LIMITS: Living room, first floor bedroom/toddler room, first floor bathroom, backyard. The isolation area will be in the first floor bedroom. OFF LIMITS: Kitchen, laundry room, entire second floor, garage. All off limit areas will be inaccessible by closed and/or locked doors and visual supervision. The applicant was advised to contact Licensing, so that an inspection can be completed prior to changing an off-limits area to on-limits. The outdoor play area will be the backyard, which has a fence surrounding the perimeter of the yard, and is free from defects or dangerous conditions. The applicant was advised to ensure that the front gate remains closed while children are outdoors. There are ample age appropriate toys, which are observed to be safe, clean and in good repair. There are no pools, hot tubs or any other bodies of water. LPA did not observe any hazardous materials or toxins accessible to children today. Knives were stored in an upper kitchen cabinet. Toxins were stored in the laundry room. Medicine/Vitamins were stored in upper kitchen cabinet and off-limits master bedroom. The home has a fully charged 2A10BC fire extinguisher which is located in the laundry room, working smoke detector above door in bedroom, carbon monoxide detector on the wall between the kitchen and laundry room, telephone, and fully stocked first aid kit. ***Continued on LIC 809C...

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: SCHAEFER, MARNI	FACILITY NUMBER: 075700232
	VISIT DATE: 07/02/2021

NARRATIVE

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Applicant submitted COVID-19 Self-Assessment Guide. LPA reviewed responses with applicant and provided technical assistance including postings.

As of today, 7/2/2021, this home is recommended for licensure of a large family childcare home. The fire clearance was approved by the San Ramon Valley Fire Department on 6/11/2021.

Exit interview conducted with Marni Schaefer. Copy of report provided.

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. Roster of the children must be properly maintained. A fire/disaster drill must completed at least every six months and must be documented. Mandated reporter requirements also discussed. Applicant received copies of various pamphlets pertaining to child's safety and parent's responsibilities. Informed the applicant that all forms can be downloaded at www.ccld.ca.gov.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: SCHAEFER, MARNI	FACILITY NUMBER: 075700232
	VISIT DATE: 07/02/2021

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Applicant has installed a child proof gate at the bottom of the stairs to prevent access by children, and is aware the gate must always be secure during daycare hours. There is also a child proof gate between the off-limits kitchen and living room. The fireplace is blocked by children’s storage shelves. Heater vents are located near the ceiling. Per applicant, there are no firearms in the home.

The applicant’s health and safety training has been completed, and pediatric CPR/First Aid is current, expiring on 5/14/23. A copy of the lease agreement has been reviewed and shows control of property. The applicant has provided proof of the immunizations required for daycare providers, and mandated reporter training was completed on 6/15/21. A packet of forms pertaining to the children’s files and facility files were reviewed and discussed, and copies were left with the applicant. Safe Sleep regulations were discussed, and new car seat laws were provided. Applicant was reminded that children are never to be left in a parked vehicle.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.

The applicant was reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. The applicant was reminded of the responsibility as a mandated reporter.

Applicant was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

***Continued on LIC 809C...

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2021

LIC809 (FAS) - (06/04)

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