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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500174
Report Date: 04/13/2021
Date Signed: 04/13/2021 04:42:18 PM

Document Has Been Signed on 04/13/2021 04:42 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:SONAWANE,ANITAFACILITY NUMBER:
394500174
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 1DATE:
04/13/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Anitia SonawaneTIME COMPLETED:
03:45 PM
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On Tuesday, April 13, 2021 at approximately 3:00 PM Licensing Program Analyst (LPA) Stacey Williams contacted Licensee Anita Sonawane for the purpose of an announced increase of capacity tele-inspection. Licensee submitted an application for an increase in capacity from 8 to 14 children. Due to COVID-19 pandemic LPA conducted the meeting via Facetime. Present during the tele-inspection was Licensee and her husband. There was one child being supervised by the Licensee.

A health and safety inspection was conducted inside and out. This facility is a two-story home which consists of 4 bedrooms, 3 bathrooms, living room, kitchen, backyard, front yard, and garage. The off-limit areas in the home will consist of: the entire upstairs, kitchen pantry and the garage. Fire extinguisher, smoke and carbon monoxide detectors meet regulation. Sharp knives , toxins and cleaning supplies are inaccessible to the children. Toys appear to be safe and appropriate for children in care. Licensee stated that there are no weapons in the home. There are no bodies of water in the home. The facility currently does not provide Incidental Medical Services – IMS. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family childcare home evaluator manual (FCCH EM) Policy 102417.

Adult residents have criminal record clearance. No additional adults have moved into the home since licensure. LPA reviewed large family childcare home capacity limitations with licensees. LPA discussed SB 277 and SB 792 pertaining to immunization requirement for children and staff and advised Licensee to visit the licensing website at www.ccld.ca.gov for current forms, laws, regulations and legislation.



Report continued subsequent page 809C----
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2021
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: SONAWANE,ANITA
FACILITY NUMBER: 394500174
VISIT DATE: 04/13/2021
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Fire Safety Inspection was granted April 2021 by French Camp McKinley Fire Prevention Mountain House Department and the home has been cleared for up to 14 children.

Safe Sleep in childcare, the effects of lead exposure brochures, COVID-19 posting documents and the use of Personal Protective Equipment during COVID-19 outbreak guidance were discussed and observed in the home.

As of today's date 04/13/21, this facility is approved for a large license, to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or elementary school and 1 child at least age 6 years old with a maximum of 3 infants.

Exit interview and appeal rights were discussed. A copy of this report, appeal rights and notice of Site Visit were emailed to the Licensee. Hard copy of the report with signature will be on file.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2021
LIC809 (FAS) - (06/04)
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