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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409651
Report Date: 10/17/2024
Date Signed: 10/17/2024 11:14:46 AM

Document Has Been Signed on 10/17/2024 11:14 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:MACWILLIAMS, VIRGINIAFACILITY NUMBER:
434409651
ADMINISTRATOR/
DIRECTOR:		MACWILLIAMS, VIRGINIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 961-8577
CITY:MOUNTAIN VIEWSTATE: CAZIP CODE:
94041
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 8DATE:
10/17/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Virginia MacWilliamsTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
NARRATIVE
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On 10/17/2024 at 9:15am, Licensing Program Analysts (LPAs) Christina Uribe and Elimika Woods conducted an unannounced Case Management Visit and met with licensee, Virginia MacWilliams. Also present today are 8 day care children and 1 fingerprint cleared assistant, Nicole Cadenas.

The purpose of today's visit is to follow up on a previous Case Management visit. During the last visit to the facility, licensee stated to LPA Uribe that a specific uncleared, excluded adult does not reside in the home and is never present during operation hours of the day care. LPA Uribe found that the following day, this uncleared adult performed a fingerprint scan and applied for a clearance to be associated to the facility and used the licensee's address as their own home address on the LiveScan application. At this time, this individual's background check is still in process and he does not have an eligible criminal record clearance or exemption and is prohibited from being present at the facility during operating day care hours.

Licensee states that the uncleared individual is not present during operating hours. LPA Uribe informed the licensee that evidence has been obtained through observations made over several days, that prove that this uncleared individual has been present inside of the home during operating day care hours.

LPA Uribe reminded the licensee that even though the criminal background check for this uncleared individual is still in process, he is not allowed to be present in the facility until after an eligible criminal record clearance has been obtained. Due to this uncleared adult being present during operating hours, a Type A Violation is being cited today on the attached deficiency page (LIC 809D).

Page 1 of 2 ***Continued on LIC 809C***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
Document Has Been Signed on 10/17/2024 11:14 AM - It Cannot Be Edited


Created By: Christina Uribe On 10/17/2024 at 10:02 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: MACWILLIAMS, VIRGINIA
FACILITY NUMBER: 434409651

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/18/2024
Section Cited
CCR
102370(d)

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Criminal Record Clearance: 102370(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department.
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Licensee will create a written statement acknowledging her understanding of the requirement to obtain a criminal background clearance or exemption for all individuals, including employees and volunteers, prior to initial presence in a licensed family child care home.
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This requirement was not met as evidenced by: Observations made and evidenced collected has found that an uncleared adult has been present in the home during operating day care hours which poses an immediate risk to the health, safety, or personal rights to children in care.
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Additionally, licensee will also confirm the removal of the uncleared individual. This written statement will be submitted to LPA Uribe at christina.uribe@dss.ca.gov within a 24-hour deadline, no later than 11:30am on 10/18/2024.

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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:Christina Uribe
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2024


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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: MACWILLIAMS, VIRGINIA
FACILITY NUMBER: 434409651
VISIT DATE: 10/17/2024
NARRATIVE
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LPA Uribe informed licensee, Virginia MacWilliams that this report dated 10/17/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Uribe informed the licensee to provide a copy of this licensing report dated 10/17/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with posting requirements will result in the issuance of an immediate $100 civil penalty. Appeal rights were given and reviewed. Exit interview conducted and report was reviewed with the licensee, Virginia MacWilliams.

Page 2 of 2 ***End of Report***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
LIC809 (FAS) - (06/04)
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