013412242-6-25-2019-52-CC-LDYN-BDGPAH-20190625110846

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013412242
Report Date: 06/25/2019
Date Signed: 06/25/2019 11:08:50 AM

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	MALHOTRA, RUP & SINGH, KULBIR		FACILITY NUMBER:	013412242
ADMINISTRATOR:	MALHOTRA, RUP		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 728-0548
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	14	CENSUS: 11	DATE:	06/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Rup Malhotra		TIME COMPLETED:	11:18 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 6/25/19 at 9:45am, Licensing Program Analyst (LPA) Loretta Dyson arrived at the home for an unannounced random inspection. LPA met with Rup Malhotra. Kulbir Singh, the licensee's fingerprint cleared assistant U. Sharma, 3 infants and 8 preschool age children were also present. At 9:50am, LPA requested and reviewed the files of 4 children in care. The licensee's CPR/first aid certificates are current and expire on 2/10/20. The licensees conduct and document fire and earthquake drills at least once every six months and the log indicates that the last fire drills were conducted on 12/27/19. The licensee was reminded that they are due to conduct drills. The facility roster was reviewed, and a copy was obtained. All required forms are posted and visible for public review. At 10:25am, LPA began a tour of the areas of the home used for the child care, to conduct a health and safety inspection. The home is neat and clean with heating and ventilation for the safety and comfort of children in care. The on limit areas include the living room, family room, kitchen, dining area, hallway bathroom, and the first bedroom in the hallway. The off limit areas include all of the other bedrooms, the bathroom in the master bedroom, and the garage. These areas are made inaccessible by closed and/or locked doors and visual supervision. The isolation area will be a section of the family room, away from other children in care. LPA observed that there is an ample supply of toys which are age appropriate and in good condition. The fully fenced backyard is used for outdoor play, and LPA observed that it is free from defects or dangerous conditions. There is a gate to prevent access to the left side of the yard where the air conditioning unit is installed. The fireplace has locked glass doors on both sides to make it inaccessible to children. There are no heaters accessible to children. LPA did not observe any bodies of water, hazardous items or toxins accessible to children today. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, first aid supplies and telephone. Per the licensee, there are no firearms in the home. continued on 809C

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: MALHOTRA, RUP & SINGH, KULBIR	FACILITY NUMBER: 013412242
	VISIT DATE: 06/25/2019

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
26
27
28
29
30
31
32

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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. The licensee stated that there are no children enrolled at this time, who require medication while in care.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. LPA reviewed the individuals associated to the license, and the licensee confirmed that everyone who is required to have a criminal record clearance is associated. Licensee was reminded of the responsibility as a mandated reporter. The licensee was advised of the required mandated reporter training to be completed as of 1/1/18, at www.mandatedreporterca.com.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to sign up to receive quarterly updates by email by sending a request to ChildCareAdvocatesProgram@dss.ca.gov. The Licensee was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet and LPA discussed safe sleep practices and policy.

There are no deficiencies being cited today. This report shall remain on file for 3 years. A Notice of Site visit was given to Licensee, and Licensee was reminded that it is required to be posted for 30 days. An exit interview was conducted with Rup Malhotra.

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2