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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500790
Report Date: 08/23/2023
Date Signed: 08/23/2023 05:58:48 PM

Document Has Been Signed on 08/23/2023 05:58 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: 6CENSUS: 5DATE:
08/23/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Paramjit KhosaTIME COMPLETED:
11:30 AM
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On 08/23/23, Licensing Program Analyst (LPA) Corina Beckby conducted a Case Management visit for the purpose of increasing the licensed capacity from 8 to 14 children. LPA met with Licensee, Paramjit Khosa. Fire Safety Inspection Clearance was granted on 08/02/23 for a total capacity of 14 children. Facility hours of operation are Monday - Friday from 08:00 am to 6:00pm. All individuals subject to criminal background review have obtained a criminal record clearance. LPA observed Licensee caring for 5 children, including 1 infant.

A health and safety inspection was conducted in all areas accessible to children. Home appears orderly and suitable for children. Off-limits areas include; Pantry, storage closet, entire second floor, garage and front yard. Hazardous items were stored inaccessible to children. Napping equipment and age-appropriate toys were observed. Licensee stated there are no weapons in the home. Home has a working telephone, a 2A10BC fire extinguisher, and a dual functioning smoke and carbon monoxide detector. The backyard is fenced for supervision. Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes. Current CPR & First Aid was verified and expires on 01/13/25. LPA reviewed large family childcare home capacity limitations with licensee.



Capacity increase is approved as of Today, 08/23/23. The facility is licensed to serve a MAX. CAP (WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6. LICENSEE UNDERSTANDS THAT WHEN ASSISTANT IS NOT PRESENT, THE CAPACITY REVERTS TO A SMALL FAMILY CHILD CARE HOME.

An exit interview was conducted, and the report was reviewed with Paramjit Khosa, to keep on file at the facility. License Appeal Rights were provided. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiencies were cited during today’s visit.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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