Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407517
Report Date: 06/03/2015 12:00:00 AM
Date Signed 06/03/2015 10:26:03 AM

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:MCKINNEY, LESLIEFACILITY NUMBER:
073407517
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
06/03/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Leslie McKinneyTIME COMPLETED:
10:30 AM
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(1) Licensing Program Analyst Chandra Charles met with licensee Leslie McKinney for an UNANNOUNCED RANDOM/INCREASE OF CAPACITY VISIT. Present for this visit was her fingerprint cleared assistant Raquel, 2 infants and 1 preschoolers. The home was toured to conduct a Health and Safety Inspection.
The home is neat and clean with central heating and ventilation for safety and comfort. The ON LIMIT AREAS are: the main playroom (aka living room/dining room), part of the kitchen (where the table area is located), the infant room off of the playroom and the bathroom in the hallway. The OFF LIMIT AREAS are the licensee children bedrooms, master bedroom, garage, kitchen area where the stove, cabinets and appliances are located and the left and right side of the backyard which will be inaccessible by barrier gates, closed and/or locked doors and visual supervision. The backyard is completed fenced. The backyard is divided into three sections; the center portion of the backyard is free from defects or dangerous conditions. There are ample age appropriate toys that appear to be safe and in good condition. There are no pools, hot tubs or any other bodies of water. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible today. The left side of the backyard is the BBQ pit area which is off limits. The right side of backyard is the deck area which is off limits to the day care children. Both sections are inaccessible by gates. The licensee has two dogs and two cats which are kept in the off limits of the backyard.
The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone, and fully stock First Aid Kit. The licensee CPR and First Aid certificate is current and expires 05/06/2016. Fireplace in the playroom is screened to prevent access by children. Per licensee, there are no firearms in the home. Children's files were reviewed and each child present has their Information and Emergency Notification form.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Chandra CharlesTELEPHONE: 510-725-7529
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2015
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: MCKINNEY, LESLIE
FACILITY NUMBER: 073407517
VISIT DATE: 06/03/2015
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Licensee is 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. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov and for day care updates visit www.myccl.gov
There are no deficiencies cited. This home is recommended for increase of capacity effective today 06/03/2015. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Chandra CharlesTELEPHONE: 510-725-7529
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2015
LIC809 (FAS) - (06/04)
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