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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423697
Report Date: 06/02/2022
Date Signed: 06/02/2022 01:10:12 PM

Document Has Been Signed on 06/02/2022 01:10 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:WALKER, MEGANFACILITY NUMBER:
013423697
ADMINISTRATOR:WALKER, MEGANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(602) 206-4522
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/02/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:13 AM
MET WITH:Megan WalkerTIME COMPLETED:
01:20 PM
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On 6/2/22 at 11:13AM. Licensing Program Analyst (LPA) Catherine Fernandes conducted an announced pre licensing inspection and met with applicant, Megan Walker. LPA disclosed the purpose of the inspection and was granted entry into the home by the applicant. Residing in the home is the applicant, her finger print cleared wife and underage daughter. Present during the inspection was the applicant and her wife. There were no children present during this inspection. The facility was toured to conduct a health and safety inspection. The facility plans to operate between the hours of 8:30AM-5:00PM, Monday -Friday.

The home is a single story house with two bedrooms and one bathroom, which is neat and clean with heating and ventilation for safety and comfort of the children.
On-limit-areas are the: the converted living/dining room, the bathroom, the patio, the backyard and the kitchen and laundry room which will be used as a walk through space to the backyard.
The Off-limit-areas are : are both bedrooms and the detached garage, which will be made inaccessible by closed and/or locked doors and visual supervision. The outdoor play area is the backyard and the patio area. There are stairs leading to the back yard that are gated at the top. The backyard is fully fenced in. The Isolation area will be the dining area. There are age appropriate toys that are observed to be safe, clean and in good repair. There are no bodies of water or pools accessible to children LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. There is a fireplace in the living room that is blocked off. The heating vents are located on the floors and were observed blocked.
The home has a fully charged 2A10BC fire extinguisher in the laundry room, a working smoke detector, a carbon monoxide detector in laundry room and a working telephone. The applicant’s Health and Safety training has been completed and First certificate expires on 11/20/2023. There is a complete first aid kit. Per licensee, there are no firearms in the home. A copy of the rental agreement was reviewed and shows control of property. The applicant completed and received a certificate in mandated reporter training on 11/2/2021.

Report Continues on 809-C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2022
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: WALKER, MEGAN
FACILITY NUMBER: 013423697
VISIT DATE: 06/02/2022
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This facility plans to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

LPA informed the applicant that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email [email protected] to be included in the Child Care Quarterly Updates distribution list. The applicant was also reminded that Mandated Reporter Training is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

The Roster for the children must be properly maintained and fire/disaster drill every six months must be documented. The applicant is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. The applicant was provided information regarding effects of Lead Exposure and testing requirements (Assembly Bill 2370). LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.
Applicant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The following needs to be completed before the license can be granted:
- Parent needs to be posted
-TB test turned in for all adults living in the home.

Exit interview conducted. Report and Appeal Rights provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022
LIC809 (FAS) - (06/04)
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