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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700268
Report Date: 10/06/2022
Date Signed: 10/06/2022 05:12:23 PM

Document Has Been Signed on 10/06/2022 05:12 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:GHOSH, REZYFACILITY NUMBER:
015700268
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
10/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Rezy GhoshTIME COMPLETED:
05:25 PM
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On 10/6/2022 at 3:10 pm Licensing Program Analyst (LPA) April Wright met with Licensee Rezy Ghosh for an unannounced Required 1-Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the home by the licensee. Present during today's were six (6) children. LPA toured the faculty to conduct a health and safety inspection. Hours of operation are 8:00am - 6:00pm.

The two story home was clean and orderly, with heating and ventilation for safety and comfort of children in care. The first floor consists of two bathrooms, a bedroom, kitchen, living/dining room, backyard, and garage. The second floor consists of three bedrooms, two bathrooms, loft, laundry room, and three storage areas. The isolation area is the living room which is a section away from other children in care.



On-limit-areas: Living/dining room (main day-care room), first floor bedroom (day-care room), first floor bathrooms and backyard
Off-limit-areas: Garage, kitchen, entire second floor.
Isolation area: Living/dining room near the couch.

The off limits area will be made inaccessible by closed and/or locked doors and visual supervision. There is a gate at the bottom of the stairs to prevent access to the upper level of the home. There are no pools hot tubs or any other bodies of water present in the on limit areas during todays inspection. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection. There are ample age appropriate toys that appear to be safe and in good condition. The outdoor side yards on both sides of the house shall remain off-limits to children



The home has a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detector, fully stocked first-aid kit and telephone. Per licensee there are no firearms in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers.
LPA requested and reviewed the files of children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The facility roster was review and copies were obtained. The licensee has not conducted fire and disaster drills per Licensing requirements. The licensee has a current CPR/First aid certificate which expires on 1/2024 and Mandated Reporter certificate expires on 8/25/2023. The licensee is in ratio today. All required forms are posted and visible for public review. See LIC809 -C for continuance
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2022
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: GHOSH, REZY
FACILITY NUMBER: 015700268
VISIT DATE: 10/06/2022
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Incidental Medical Services (IMS) policy was discussed.No IMS providedat facility. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm

California Law requires Child Care Centers 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, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

The licensee is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. The licensee was provided information regarding effects of Lead Exposure and testing requirements(Assembly Bill 2370)

LPA discussed the Safe sleep regulations with licensee and discussed Child Care Licensing Safe Sleep web page 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.



Licensee was reminded that all adults 18 and over, 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 child care center. 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.

No deficiencies are cited during today's inspection.

Please see list below and attached LIC9102 advisory notes for additional information about technical violations issued today:

  • Technical Violation: Licensee not conducting fire/disaster drills as required.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Rezy Ghosh
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
LIC809 (FAS) - (06/04)
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