013415834-1-9-2020-52-CC-EWOS-BKNNV6-20200109094725

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013415834
Report Date: 01/09/2020
Date Signed: 01/09/2020 09:47:30 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:	PRASAD, SHARINA		FACILITY NUMBER:	013415834
ADMINISTRATOR:	PRASAD, SHARINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 293-9623
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94544
CAPACITY:	14	CENSUS: 3	DATE:	01/09/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Sharina Prasad		TIME COMPLETED:	10:00 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 01/09/2020, at approximately 8:30 AM, Licensing Program Analyst Elimika Woods (LPA) met with licensee Sharina Prasad, to conduct an unannounced Annual Random Inspection. Present during the inspection licensee's fingerprint cleared associate Ryan Prasad, two preschool aged children, and one infant. LPA Woods conducted a Health and Safety Inspection with the licensee. Licensee stated hours of operation are from 7:00 AM to 5:30 PM., Monday through Friday. On-limit-areas are the: Living and dining room, kitchen, family room, backyard, bathroom next to family room Off-limit-areas are the: All bedrooms, left and right side of the backyard, garage, shed This home is a single-story home, which is neat and clean with heating and ventilation for safety and comfort. The off-limits are will be made inaccessible by closed and/or locked doors and visual supervision. The home has a fully fenced outdoor play area that is available for children in care. The Isolation area will be a section of the family room away from other children in care. There are ample age appropriate toys that appear to be safe and in good condition. There are no pools, hot tubs or any other bodies of water present in the on-limit areas during today's inspection. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, and telephone. Licensee's CPR and First Aid certificate is current and expires 09/08/2020. The heaters and fireplace are screened to prevent access by children. Per licensee, there are no firearms in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers. The licensee completed and received a certificate in mandated reporter training on 07/04/2018. All required forms are posted and visible for public review. See 809-C for continuation

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PRASAD, SHARINA	FACILITY NUMBER: 013415834
	VISIT DATE: 01/09/2020

NARRATIVE

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At 8:45 AM, LPA Woods requested to review one (1) children’s facility files. Each file contained completed Identification & Emergency forms, Medical Consent, and Parents Rights.

Incidental Medical Services (IMS) -Per the licensee, there are no children on any form of medication. The licensee is not providing IMS currently.

LPA reminded the licensee of the following; Mandated Reporter training is to be renewed every two years, CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. LPA discussed Unusual Incidents Reports.

The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing.

The licensee was 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. The licensee was reminded of the responsibility as a mandated reporter.

The licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet.

There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020

LIC809 (FAS) - (06/04)

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