015700213-3-19-2021-52-CC-RHAR-BZ9T83-20210319142941

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700213
Report Date: 03/19/2021
Date Signed: 03/19/2021 02:29:54 PM

Document Has Been Signed on 03/19/2021 02:29 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:	SINGH, NEETU		FACILITY NUMBER:	015700213
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	03/19/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:14 PM
MET WITH:	Neetu Singh		TIME COMPLETED:	02:50 PM

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On March 19, 2021 at approximately 12:14 pm Licensing Program Analyst (LPA) Russ Haderer and LPA Lorraine Dacanay Breaux met with applicant Neetu Singh for the purpose of conducting an announced pre-licensing inspection for Health and Safety compliance. Living in the home is the applicant, her 17 year old son and her fingerprint cleared and TB tested husband. Present today was the applicant, her husband and son. The hours of operation will be Monday-Friday, 8:30AM to 6:00PM.

The facility is a single story 3 bedroom, 2 bath home with an attached two-car garage. It is rented by the applicant and contains a dining room, family room, kitchen, three bedrooms and two bathrooms, an enclosed (fenced) side and backyard area. The home is neat and clean with heating and ventilation for safety and comfort. Per the applicant, the ISOLATION AREA will be on the sofa in the family room away from the other children in care.

On-limit-areas include: Dining room, family room, kitchen, the first bedroom on the right side of the hallway, the main house bathroom at the end of the hall, the gated and locked side yards and back yard area. All exterior gates have latches with padlock availability. Applicant was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area.

Off-limit-areas include: Master bedroom and bathroom, second bedroom on the right hand side of the hallway, next to the house bathroom and across from master bedroom, and attached garage. The off-limit area will be inaccessible by closed and/or locked doors, and/or by child supervision.

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SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2021

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: SINGH, NEETU	FACILITY NUMBER: 015700213
	VISIT DATE: 03/19/2021

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LPAs provided a copy of Safe Sleep-in Child-Care brochure, a handout "What Does A Safe Sleep Environment Look Like?" and a copy of the new California Car Seat Law Changes.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and advised to be added to the email list.

Once the items listed below are in place, and an inspection has been done (or photos sent to LPA) to confirm it, a full license may be issued.

Items needed before license issue:
- Affix fire extinguisher bracket to wall in the kitchen
- Padlock on the south backyard gate
- Repair the latch to gate on the west side of yard
- Purchase napping pads for children to sleep
- Purchase a Pack and Play or approved crib for infants to sleep
- Place Bungee Cords on the barbecue cover

A review of operating safely during the Covid-19 pandemic (RAST) was conducted.

Exit interview was conducted with applicant, LPAs left the home at 2:50pm.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2021

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: SINGH, NEETU	FACILITY NUMBER: 015700213
	VISIT DATE: 03/19/2021

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There is a double-sided fireplace (accessible from dining room and living room) with glass doors containing child proof locks and one side also blocked with a portable shelving/toy rack. Per applicant, there are no firearms in the home. A copy of the rental agreement was reviewed and a property owner consent form was signed. Ratios were discussed and a copy left for applicant as a reminder.

Applicant has ample age-appropriate toys and learning materials. The home has a fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detectors (tested and functioning), and a working telephone. The applicant’s Health and Safety training is completed, and CPR and First Aid certificate is current and expires 02/20/2023. The applicant completed and received a certificate in mandated reporter training (verified AB1207), expires on 02/02/2023. The applicant is in compliance with the immunization laws which pertains to day care providers.

LPA reminded the applicant of the following; Mandated Reporter training is to be renewed every two years, CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. LPA discussed Unusual Incidents Reports.

LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during the inspection.

Applicant 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. Applicant was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information 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

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2021

LIC809 (FAS) - (06/04)

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