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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101337
Report Date: 01/17/2023
Date Signed: 01/17/2023 02:35:24 PM

Document Has Been Signed on 01/17/2023 02:35 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:UDIMUDI, PRASANTI FAMILY CHILD CAREFACILITY NUMBER:
376101337
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/17/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Prasanti UdimudiTIME COMPLETED:
02:45 PM
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On 01/17/2023 at 12:40pm, Licensing Program Analyst (LPA), Selina Siao conducted a pre licensing inspection with applicant. The 4 bedroom, 3 bath two stories house was toured and inspected to ensure an environment safe for the care and supervision of children. The home has a fully charged fire extinguisher size 3A40BC, smoke and carbon detector that meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. The home has a spa with cover that can withhold the weight of an adult. Applicant stated that the home doesn't have any weapon. Applicant has an EMSA approved pediatric CPR and First Aid card that are current due to expire on Dec 2024 and she completed the 8 hours preventative health practice course on 11/09/2022. Applicant completed the online mandated child abuse training on 11/02/2022 and she was reminded that it must be renew every two years. A review of the application and records on this date indicates that applicant and her husband are the current adult residents at the home with the require TB clearances, caregiver background checks and child abuse clearances. Applicant has the required immunizations. Applicant and her husband owns the home and has provided proof of control to the department.
Applicant will be using the following areas for childcare: living room, dining room and bathroom. The home has a fireplace in the family room that is inaccessible to children. Off limit areas includes: kitchen, family room, bedroom located downstairs, garage and all of upstairs. All off limit has a gate or safety latch to prevent children's access. There is a gate at the bottom of the stairs to prevent children's access. Outdoor area will be the fenced backyard and the children has to walk through the family room in order to go to the backyard therefore an adult has to escort the children at all time to and from the backyard.

Applicant was reminded of requirements for children’s records, facility roster, child abuse and unusual incident reporting, immunizations, car seat law, shaken baby syndrome, and SIDS. Applicant was reminded that corporal punishment, smoking, baby walkers, exersaucers, bouncy seats and baby jumpers are not allowed in day care. The ABC’S of Safe Sleep: Sleep is Safest: Alone, on their Back in an empty Crib on a firm mattress.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023
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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: UDIMUDI, PRASANTI FAMILY CHILD CARE
FACILITY NUMBER: 376101337
VISIT DATE: 01/17/2023
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Applicant shall comply with all regulations and laws governing family childcare homes and be financially secure to operate a family childcare home for children.

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.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage 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.

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

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
Entrance Checklist was provided to the applicant.

All unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619)767-2203.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2023
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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: UDIMUDI, PRASANTI FAMILY CHILD CARE
FACILITY NUMBER: 376101337
VISIT DATE: 01/17/2023
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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.

The home appears to be within substantial compliance during today’s inspection and a license will be granted effective today.

Exit interview conducted and report was reviewed with the applicant. .
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2023
LIC809 (FAS) - (06/04)
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