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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423704
Report Date: 04/28/2023
Date Signed: 04/28/2023 03:18:15 PM

Document Has Been Signed on 04/28/2023 03:18 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:TAM, WING YEE MAEGANFACILITY NUMBER:
013423704
ADMINISTRATOR:TAM, WING YEE MAEGANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 430-0185
CITY:BERKELEYSTATE: CAZIP CODE:
94703
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
04/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:18 PM
MET WITH:TIME COMPLETED:
03:25 PM
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On April 28, 2023 at 2:18pm Licensing Program Analyst (LPA) Indira Loza met with Licensee Maegan Tam for an Unannounced Required Annual Inspection. Present during the inspection were the Licensee, and two fingerprint cleared assistants. The home was toured for a health and safety inspection. The facility operates from 8:00am – 5:00pm Monday – Friday.

The Home has two bedrooms and one bathroom. ON LIMIT AREAS ARE: The backyard, the Living room, the bathroom, and the bedroom to the left of the bathroom which is being used as a napping room. OFF LIMIT AREAS are the Kitchen and the Licensee's bedroom which is located to the right of the bathroom. The home is a duplex with a daycare operating nextdoor, the facility (#013423619) shares the large play yard with this facility. Licensee is reminded that no commingling of children will be allowed between both licensed facilities.

The room floors, surfaces, furniture and equipment appear to be safe, sanitary and in good repair. The furniture, equipment and activities appear to be age appropriate for the children in care. The heating and lighting is adequate. LPA Loza did not observe any bodies of water, free standing water, cleaning supplies, or toxic items accessible to children during todays inspection. The Licensee provides the food and drinks to the children. LPA Loza observed a shaded area and age appropriate toys, that appear to in good repair. All required documents are posted for public review. The home is equipped with a working telephone, carbon monoxide detector, a smoke detector, a pull down fire alarm near the front door, and a 2A10BC fire extinguisher in the kitchen.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02. 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
*******************************Report Continues on LIC 809-C***********************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/28/2023
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: TAM, WING YEE MAEGAN
FACILITY NUMBER: 013423704
VISIT DATE: 04/28/2023
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Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted
Report and Appeal Right were provided to Licensee Maegan Tam.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023
LIC809 (FAS) - (06/04)
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