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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423308
Report Date: 08/04/2021
Date Signed: 08/04/2021 04:08:55 PM

Document Has Been Signed on 08/04/2021 04:08 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:NLN, LOVEPREETFACILITY NUMBER:
013423308
ADMINISTRATOR:NLN, LOVEPREETFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 401-7634
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
08/04/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Lovepreet NLNTIME COMPLETED:
04:21 PM
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On 8/4/2021 at 2:20pm, Licensing Program Analyst (LPA) Jonathan Williams met with Licensee, Lovepreet NLN, for a Required 1 Year Inspection. Present for this inspection are the Licensee, one fingerprint cleared and associated assistant, and four napping children in care (all infants). The facility was toured to conduct a Health and Safety Inspection.

The home is a 1-story home. The ON LIMIT AREAS are the living room which has been converted into a playroom/classroom, kitchen, family room, the first and second rooms on the right side of the hallway, the patio located between the first and second bedrooms on the right side of the hallway, and the hallway bathroom. The OFF LIMIT AREAS are garage, the master bedroom/bathroom and the bedroom located on the left side of the hallway, all of which will be made inaccessible to children by closed and/or locked doors and visual supervision. The ISOLATION ROOM is the bedroom on the right side of the hallway and across from the hallway bathroom.

The facility interior was toured at 2:20pm. LPA observed the interior to be tidy and clean with heating and ventilation for safety and comfort. There are toys and learning materials in the facility. All hazardous materials and toxins were observed to be made inaccessible to children during today's inspection. Per Licensee, there are no firearms kept in the home. There is a fireplace in the home which is barricaded to prevent access to children.

The backyard was toured at 2:40pm. Backyard is fenced. LPA observed there to be ample toys and play equipment in the backyard during this inspection. LPA observed all items in the backyard to be safe and age-appropriate during this inspection. There are no pools, hot tubs, ponds, or any other bodies of water on the facility premises during this inspection.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2021
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: NLN, LOVEPREET
FACILITY NUMBER: 013423308
VISIT DATE: 08/04/2021
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The facility has a fully charged 2A10BC fire extinguisher, working telephone, and fully stocked first aid kit. LPA confirmed smoke detector and carbon monoxide detector to be functional. Licensee has current CPR/1st Aid training which expires on 10/12/2021. Licensee has a signed affidavit from assistant provider stating that she will take Mandated Reporter training when it becomes available in Hindi or Punjabi. The facility is in ratio today. Children's files and staff files were reviewed for proper documentation. Facility roster was obtained. Facility conducts fire/disaster drills at least once every 6 months.

Incidental Medical Services (IMS) policy was discussed. This faciltiy does not provide IMS at this time. 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.”

Licensee was 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 that California Law requires licensed Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624b). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the Licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the Licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

There are no deficiencies cited. This report shall remain on file for 3 years. A Notice of Site Visit was provided to the Licensee. LPA reminded the Licensee to post the Notice of Site Visit where it is clearly visible inside the facility for 30 days. Appeal rights were provided to the Licensee. Exit interview was conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021
LIC809 (FAS) - (06/04)
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