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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418329
Report Date: 08/02/2023
Date Signed: 08/02/2023 01:09:00 PM

Document Has Been Signed on 08/02/2023 01:09 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:GRIFFIN, CARRIE AFACILITY NUMBER:
013418329
ADMINISTRATOR:GRIFFIN, CARRIE AFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 562-4689
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 0DATE:
08/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:32 AM
MET WITH:Carrie GriffinTIME COMPLETED:
01:15 PM
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On 8/2/2023 at 10:32am, Licensing Program Analysts (LPAs) Catherine Fernandes and Randall Dunevant met with Licensee Carrie Griffin for an Unannounced Required Annual Inspection. Present during the inspection was the Licensee, there were no children in care. Residing in the home is Licensee. Licensee’s home was toured for a health and safety inspection. The facility operates 6:30am – 6:00pm, Monday - Friday.

The house is a single story home that consists of three bedrooms and one bathroom. 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. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. During today’s inspection, LPA observed the following precautions the home has safety gates and hooks to prevent access. Licensee has stated that there are no firearms, there is a dog that lives in the home and is around the children in care.

ON LIMITS AREA: the two bedrooms that are connected towards the right side of the house. The first bedroom is the main area of the day care, the bathroom, the kitchen, living room, the dining room and the two enclosed backyards.


OFF LIMITS AREA: the master bedroom, the detached garage, the left side of the backyard that is gated off and the laundry room next to the kitchen which will be inaccessible by closed and/or locked doors or visual supervision.
ISOLATION AREA: the back room located in-between the backyard and the main area of the day care.
The home has a fully charged 2A10BC fire extinguisher located in the back room and a working smoke detector in the living room, a plug in carbon monoxide detector in the living room and a push button fire alarm in the hallway. The Licensee has a working telephone, and all required forms are posted and visible for public view in the living room. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 6/22/2023 The Licensee's CPR and First Aid certificate was completed however it was done online. Licensee will schedule the correct CPR training. The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required training for which was conducted on 1/19/23. LPA did not observe any bodies of water in or around the home. LPA reviewed five the children’s files, two staff files and obtained a current facility roster.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2023
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: GRIFFIN, CARRIE A
FACILITY NUMBER: 013418329
VISIT DATE: 08/02/2023
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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 [email protected]. 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.

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 webpage 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

During the exit interview, the Licensee Griffin, 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 and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Carrie Griffin

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023
LIC809 (FAS) - (06/04)
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