073409274-10-6-2023-02-CC-CWAS-CWCPWG-20231006114042

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409274
Report Date: 10/06/2023
Date Signed: 10/06/2023 11:40:48 AM

Document Has Been Signed on 10/06/2023 11:40 AM - 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	CHAUHAN, SHABANA PARVEEN		FACILITY NUMBER:	073409274
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 6	DATE:	10/06/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Shabanna Chauhan		TIME COMPLETED:	11:45 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/06/2023 at 9:10 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced case management – licensee initiated for Shabana Parveen Chauhan's small family child care home. LPA met with licensee and guided analyst on a tour of the facility. During today's inspection, there were 6 children in care (3 infants, 2 preschool aged children and 1 school age child) and 8 children enrolled. Also present during inspection was licensee, licensee's husband, licensee's minor child age 12 years old and a assistant. Family members residing in the home are licensee, licensee husband and licensee's minor child aged 12 years old. Licensee and all adults in the home have Criminal Record Clearance. Facility hours of operations are Monday - Friday from 7:00 AM - 6:30 PM. Licensee completed her Pediatric CPR/First Aid certificate which expires 07/2024 and Mandated Reporter certificate which expires 07/2024. Licensee has documentation maintained for Measles, Pertussis Immunization's, Influenza Opt-Out statement for the current flu season. The licensee provided proof of control of property. There is a working telephone in the home. Fire clearance request was approved on 09/19/2023 by Inspector Nicole Donovan of the Contra Costa County Fire Protection Department. Per the Fire Safety Inspection Request dated 09/19/2023, the facility is limited to the first floor and the second floor and garage are off limits and cannot be used for daycare purposes. This is a two story home which consists of 3 bedrooms, 2 1/2 bathrooms, kitchen, dining room, living room, upstairs loft, laundry room, attached garage, and backyard. The children on limits areas: Living Room, Dining Room, Downstair Half Bathroom and backyard (center and left side of backyard.) Licensee will be utilizing the living room as the main room for her day care area. Areas off limits include: The entire second floor which includes 3 bedrooms, upstairs loft, upstairs bathroom, master bathroom, laundry room, right side of backyard, and attached garage. The LPA toured all areas used by children during this visit. *CON'T ON PAGE 2*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

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: CHAUHAN, SHABANA PARVEEN	FACILITY NUMBER: 073409274
	VISIT DATE: 10/06/2023

NARRATIVE

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*PAGE 2*

Per licensee, there are no firearms or weapons in the home. LPA did not observe a fireplace in the facility. LPA observed a fully charged 2A10BC fire extinguisher, working dual smoke and carbon monoxide detector. There are stairs in the home that are made inaccessible for children in care. Medicines, cleaning products, sharp objects are stored inaccessible to children. LPA reminded licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes.

OUTDOOR SPACE: Per the last report 08/04/2023, the backyard was off limits due to construction. Licensee stated the construction is done and would like the backyard to be placed on limits. LPA toured the outdoor area and observed a fully fenced backyard safe for children in care. LPA observed age appropriate toys for children to play with. LPA did not observe any bodies of water. AS OF 10/06/2023, BACKYARD IS PLACED ON LIMITS. LPA reminded licensee when outside of facility, 100% supervision of children in care is required. Facility does provide transportation for children, but licensee understands that children cannot be left alone, unattended in parked vehicles.

LPA discussed and reminded licensee day care needs to be operated within the limitations and capacity of a Large Family Child Care Home with regards to ratios and that Licensee has to be present in the day care for 80% of the operation hours. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication. LPA provided the main office number for the Oakland Regional Child Care office (510) 622-2602. Licensees are to call and report injuries or unusual incidents within 24 hours of knowledge of occurrence. Licensees are to review the form (LIC 624B) to follow up in writing within 7 days of the injury/unusual incident.

*CON'T ON PAGE 3*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: CHAUHAN, SHABANA PARVEEN	FACILITY NUMBER: 073409274
	VISIT DATE: 10/06/2023

NARRATIVE

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*PAGE 3*

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.

Licensee 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.

Effective as of 10/06/2023, change of capacity application has been approved.

During today's inspection, there were no violation observed.

Exit interview conducted and report was reviewed with the licensee, Shabana Chauhan. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

LIC809 (FAS) - (06/04)

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