073409318-9-12-2022-02-CC-MMAR-CJ7NU9-20220912104559

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409318
Report Date: 09/12/2022
Date Signed: 09/12/2022 10:46:13 AM

Document Has Been Signed on 09/12/2022 10:46 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:	RAPOPORT, MUSHKA		FACILITY NUMBER:	073409318
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	09/12/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Mushka Rapoport		TIME COMPLETED:	11:00 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 9/12/22 at 8:45 am Licensing Program Analyst (LPA), Monica Mathur conducted an announced Pre-licensing Inspection at Mushka Rapoport's home and met with Applicant, Mushka Rapoport who has applied for a Small Family Child Care Home with a capacity of eight (8). Days and hours of operation will be Monday – Friday from 8 am - 6 pm. Applicant completed 8-hour Preventative Health & Safety training, Nutrition and Lead Poisoning training, 8-hour Pediatric CPR & First Aid, has documentation for Measles, Pertussis, Influenza opt out statement for the current flu season. Applicant and spouse live in the home have Criminal Record and Child Abuse Index Clearance and documentation for Tuberculosis (TB) clearance. Applicant has 4 children under age 10 living in the home. Applicant rents the home. LPA reminded that when care for more than six and up to eight is provided, Applicant must notify parents and get landlord consent. Applicant will use the Affidavit Regarding Liability Insurance form to inform parents they do not carry a day care insurance. Applicant has a working telephone in the home. Home is single story home . Areas to be used for day care: Children will enter from driveway gate into the Front Yard, Playroom 1, Playroom 2, Bathroom in Hallway. Off-Limit Areas: Master Bedroom, Master Bathroom, Kids bedroom, Kitchen, Closets in Hallway, Laundry, Storage room and Bathroom behind the Kitchen. On Limit (Isolation Area) Living room couch LPA toured the indoor space of the home. It is sanitary and orderly, with heating and ventilation for safety and comfort. There are no stairs in the home. Fireplace is located in the Living Room and is screened/barricaded. LPA observed fully charged fire extinguisher that meets state standards, working smoke, carbon monoxide detector.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: RAPOPORT, MUSHKA	FACILITY NUMBER: 073409318
	VISIT DATE: 09/12/2022

NARRATIVE

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Medicines, cleaning products, sharp objects are stored inaccessible to children in cabinets with latches and locks. Door access to off limit areas are locked. LPA reminded that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. No pets or arms stored in the home.

Applicant was reminded that Play Room 2 which is a converted garage cannot be used for eating or sleeping since it does not have a fire clearance. It can only be used for activities and children need to be supervised at all times.

Outdoor Area: Children will use the Left Yard in between the Detached Play Room 2 and Main House. The In-use Yard shares a common fence between a child care center next door. Applicant was reminded that day care children cannot move back and forth between her family child care home and center.
Off Limit: Right Side Yard and Storage Shed is accessible from the Living Room The yard has fences on all sides. No bodies of water were observed.

Discipline policy was discussed, and Applicant states she will talk to the children as form of discipline. She understands that children's personal rights should not be violated and no corporal punishment. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries and requirements for assistant/substitute were also discussed. Fire drills must be practiced once every six months and documented. A Family Child Care Home packet was provided to and reviewed with the Applicant.

LPA reviewed with Applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

LPA discussed and reminded Applicant day care needs to be operated within the limitations and capacity of a Small 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. 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: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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: RAPOPORT, MUSHKA	FACILITY NUMBER: 073409318
	VISIT DATE: 09/12/2022

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LPA discussed the safe sleep regulations with Applicant, and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 licensed Family Child Care Home. 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.

Website links for provider resources:

Licensing forms, Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov.

Guardian Background Check System:
www.guardian.dss.ca.gov

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Applicant signed up during inspection.

Facility is recommended for license for Small Family Childcare Home, subject to approval by Management. Exit interview conducted and report was reviewed with the Applicant

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC809 (FAS) - (06/04)

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