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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500790
Report Date: 08/09/2023
Date Signed: 08/10/2023 05:06:24 PM

Document Has Been Signed on 08/10/2023 05:06 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KHOSA, PARAMJITFACILITY NUMBER:
394500790
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
08/09/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Paramjit KhosaTIME COMPLETED:
02:00 PM
NARRATIVE
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On August 9, 2023, Licensing Program Analyst (LPA) Corina Beckby met with Licensee, Paramjit Khosa, for the purpose of a licensee initiated case management inspection to increase the change of capacity from 8 to 14. There were 7 children present at the time of inspection (including 4 infants). Licensee's operating hours are Monday through Friday from 8:00 AM. To 6:00PM. Fire clearance was granted by Tracy Fire Department on 8/2/2023. LPA verified the annual fees are current.

Licensee stated there are no new residents in the home since licensure. All adults subject to criminal background review have obtained criminal record clearance. Licensee was reminded that all adults 18 and over living or working in the home, 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.

The OFF-limits areas of the FCCH are the pantry, storage closet, the entirety of the 2nd floor, garage, and the front yard. LPA observed 7 children present (4 infants and 3 preschoolers). A health and safety inspection was conducted in all areas accessible to children. LPA did not observe the required postings. LPA observed a functioning dual smoke and carbon monoxide detector. A 2A10BC fire extinguisher was observed in the storage closet. Licensee does not have cribs/portable cribs for infants. Licensee did not have a current roster. Licensee has not conducted fire drills since opening in March. LPA informed Licensee the importance of conducting disaster drills every six months. LPA reviewed 6 children’s files, all which are incomplete. LPA did not observe 15-minute observation checks for napping infants. Preventative health and current pediatric CPR and first aid training was verified for Licensee, and CPR expires 1/13/25. Mandated Reporter Training certificate expires: 1/6/25. Licensee understands the training must be completed once every two years, and training is accessible at www.mandatedreporterca.com.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: KHOSA, PARAMJIT
FACILITY NUMBER: 394500790
VISIT DATE: 08/09/2023
NARRATIVE
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LPA rediscussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA discussed the requirement to check and log infant napping every 15 minutes, for infants under 24 months.

During the exit interview, the Licensee, Khosa Parmjit, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA informed Licensee, Khosa Paramjit, that this report dated 8/9/2023, documents Type A citations that are an immediate Health and Safety, or Personal Rights risk to persons in care. In addition, a Type B citation was issued that is a potential Health and Safety, or Personal Rights risk to persons in care. A separate 809D is issued for each deficiency on subsequent page.

Upon receipt of a Type A deficiency licensee shall post the report for 30 days in addition to the Notice of Site Visit and provide copies of the licensing report to parents/guardians of children in care at the facility. This report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and licensee will obtain a signed Acknowledgment of Licensing Reports (LIC9224) from parent/guardian and place it in each child's file. If these requirements are not met, civil penalties will be assessed.

Change of Capacity is denied until all deficiencies are corrected.

An exit interview was conducted and report was reviewed with the licensee, Paramjit Khosa. A copy of this report will remain on file for a period of three years for public review upon request. Licensee's signature on this form acknowledges receipt of this form. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 08/10/2023 05:06 PM - It Cannot Be Edited


Created By: Corina Beckby On 08/09/2023 at 12:07 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KHOSA, PARAMJIT
FACILITY NUMBER: 394500790

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/10/2023
Section Cited
CCR
102416.5(b)(1)(2)

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102416.5 (b)(1)(2) Staffing Ratio and Capacity
For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be
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Licensee will permanently disenroll 1 infant and temporarily disenroll another infant until the infant turns 2. LPA provided Licensee a ratio chart which will be posted for visual reference. Licensee wrote a statement saying she understands the ratio for small family child care home and will comply.
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one of the following: (1) Four infants; (2) Six children, no more than three of whom may be infants;
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LPA will conduct an unannounced visit to clear deficiencies.
Type A
08/10/2023
Section Cited
CCR102425(j)(2)(D)

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102425 (j)(2)(D) Infant Safe Sleep
(j) The provider shall supervise infants while they are sleeping and adhere to the following requirements: (2) The provider shall check and document the following:
(D) Documentation shall be maintained in
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LPA reviewed Safe Sleep Regulations with Licensee, again. LPA provided another example of safe sleep log and discussed what to record every 15 minutes. LPA will conduct an unannounced visit to clear deficiencies.
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in the infant’s file and be available to the Department for review. Documentation shall include the following:
a. Date.
b. Infant’s name.
c. Time of each 15-minute check.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Bettina Engelman
LICENSING EVALUATOR NAME:Corina Beckby
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/10/2023 05:06 PM - It Cannot Be Edited


Created By: Corina Beckby On 08/09/2023 at 12:10 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KHOSA, PARAMJIT
FACILITY NUMBER: 394500790

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/10/2023
Section Cited
CCR
102425(a)

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102425 (a) Infant Safe Sleep
There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

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Licensee will provide play yards for 2 infants and have them set up and ready. LPA will conduct unannounced visit to clear deficiencies.
Type A
08/10/2023
Section Cited
CCR
102418(a)

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102418(a) Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.
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Licensee will provide immunization records for every child enrolled by due date and have it ready for record review when LPA conducts unannounced visit to clear deficiencies.
Type A
08/10/2023
Section Cited
CCR102417(g)(8)

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102417(g)(8) Operation of a Family Child Care Home
Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
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Licensee will complete and enter all information required for all children on current roster and have it ready for record review when LPA conducts unannounced visit to clear deficiencies.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Bettina Engelman
LICENSING EVALUATOR NAME:Corina Beckby
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/10/2023 05:06 PM - It Cannot Be Edited


Created By: Corina Beckby On 08/09/2023 at 12:14 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KHOSA, PARAMJIT
FACILITY NUMBER: 394500790

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/11/2023
Section Cited
CCR
102419(b)

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102419(b)
Admission Procedures and Parental and Authorized Representative's Rights
The licensee shall post the PUB 394 (8/02), Family Child Care Home Notification of Parents’ Rights Poster
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Licensee will have all requried postings (Parents Right Poster, License, Emergency Disaster Plan, Earthquake Readiness checklist and Facility Sketch) by entrance door. Licensee will send a picture of correction by due date.
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in a prominent, publicly accessible area in the family child care home at all times children are in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Bettina Engelman
LICENSING EVALUATOR NAME:Corina Beckby
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023


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