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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700019
Report Date: 09/19/2024
Date Signed: 09/19/2024 04:40:46 PM

Document Has Been Signed on 09/19/2024 04:40 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:AEIMULA, ANILFACILITY NUMBER:
015700019
ADMINISTRATOR/
DIRECTOR:		AEIMULA, ANILFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(225) 368-6002
CITY:PLEASANTONSTATE: CAZIP CODE:
94588
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
09/19/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:10 PM
MET WITH:Anil AeimulaTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On September 19, 2024, at approximately 03:10PM, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux met with Licensee Anil Aeimula for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during the inspection was the licensee's fingerprint cleared wife/staff, Priyanka Boga and eight (8) children in care, three (3) infants and five (5) preschool age children. Licensee stated that the facility operates from Monday to Friday 8:00 AM to 6:00 PM.

This single story home with 3 bedrooms and two bathrooms. LPA toured the home for health and safety inside and outside. The home has adequate with lighting, heating and ventilation for the safety and comfort of children in care. Per licensee this facility provides meals and snacks.

On Limits: Child care room/living and dining room, kitchen, backyard deck and backyard, and main bathroom. Off- Limit: All three (3) bedrooms which includes master bedroom and bathroom, left side and right side of the yard and two garage. The off-limits are will be made inaccessible by closed and/or locked doors and visual supervision. The Isolation area will be a section of the living room, away from other children in care, until parents pick up.

OUTDOOR AREA: The rear yard is used for outdoor play, it is fully fenced. During today's inspection, there are no play structures which are required to be anchored. There are no pools, hot tubs or any other bodies of water present in the on-limit areas during today's inspection. Licensee confirmed there are no pools and/or bodies of water at the home. There are age appropriate toys that appear to be safe and in good condition. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection.


LIC 809C***
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: AEIMULA, ANIL
FACILITY NUMBER: 015700019
VISIT DATE: 09/19/2024
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The home has a fully charged 3A40BC fire extinguisher (located in the kitchen), dual working smoke detector/carbon monoxide detector (tested/functioning) located in the hallway, fully stocked first aid kit, and working telephone. There's no fireplace or heaters accessible to children. Per licensee, there are no firearms and no pets in the home. Per licensee resides in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers. LPA asked the licensee does he transports children and the licensee stated that he does not transport children. Licensee does have liability insurance expires 05/13/25.

At 03:30 PM LPA requested and reviewed the files of five (5) children in care and personnel files. All children’s files contain Immunization, Identification & Emergency Information, Parent's Rights, and Medical Consent forms and the staff file has the required Employee Rights and Statement Acknowledging Requirement to Report Child Abuse. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 06/12/2024. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires on 05/13/2025. The licensee has completed mandated reporter training on 04/26/24.

Effective August 1, 2003, California Law requires 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 624). Incidents must be reported within 24 hours by phone to regional office.

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/.



Per licensee does not administer medication at this time.

See 809-C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: AEIMULA, ANIL
FACILITY NUMBER: 015700019
VISIT DATE: 09/19/2024
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LPA discussed the safe sleep regulations with the facility representative 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 the facility representative 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.

The facility representative 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.

MyChildCarePlan.org: Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Megan’s Law: During the exit interview, the licensee, Anil Aeimula confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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 inspectionprocess@dss.ca.gov. 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.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the licensee, Anil Aeimula.

END of REPORT

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC809 (FAS) - (06/04)
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