013418570-5-15-2019-52-CC-JPLA-BC7TQZ-20190515145646

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013418570
Report Date: 05/15/2019
Date Signed: 05/15/2019 02:56:58 PM

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:	KAPOOR, RASHI		FACILITY NUMBER:	013418570
ADMINISTRATOR:	KAPOOR, RASHI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 797-2640
CITY:	FREMONT	STATE: CA	ZIP CODE:	94555
CAPACITY:	14	CENSUS: 6	DATE:	05/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Rashi Kapoor		TIME COMPLETED:	03:10 PM

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	Licensing Program Analyst (LPA) Julia Placencia arrived at 1:45pm for an unannounced Annual/Random Inspection, and met with Licensee Rashi Kapoor. Present for this inspection were two infants, four preschool age children, and the licensee's fingerprint cleared helper Ramandeep Kaur. Also residing in the home are the licensee's fingerprint cleared spouse and daughter. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8:30am to 6:00pm. ON LIMITS: Kitchen, living room, family room, first floor bathroom, backyard. OFF LIMITS: Second floor, garage, shed in backyard. Off limit areas are inaccessible by closed and/or locked doors and visual supervision. The home is two story, which is neat and clean, with heating and ventilation for safety and comfort. The stairway had a child safety gate in place. The outdoor play area is fenced, and is free from defects and dangerous conditions. There were ample age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. There is a fully charged 3A40BC fire extinguisher, working carbon monoxide and smoke detectors, telephone, and first aid kit. The fireplace has a glass cover. Per licensee, there are no firearms in the home. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 1/24/19. All required licensing documents are posted and visible for public review. At 2:05pm, children's files were reviewed and found to be complete. The facility roster was reviewed, and a copy obtained. The licensee is in ratio today. Liability Insurance Affidavit is used in place of day care insurance. The licensee's Pediatric CPR/First Aid certificate is current and expires 3/17/21, helper Ramandeep's expires 6/2/20. Licensee and helper have proof of the required immunizations, Safe Sleep practices were discussed, and new car seat laws were provided. Licensee was reminded that children are never to be left in a parked vehicle. The licensee was advised of the required mandated reporter training to be completed as of 1/1/18, at www.mandatedreporterca.com. ***Continued on LIC809C...

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019

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: KAPOOR, RASHI	FACILITY NUMBER: 013418570
	VISIT DATE: 05/15/2019

NARRATIVE

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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.

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.

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.

There were no deficiencies cited during today's inspection. This report shall remain on file for 3 years. A Notice of Site visit was posted at time of inspection and must remain posted for 30 days.

Exit interview conducted with Rashi Kapoor. Copy of report and appeal rights provided.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019

LIC809 (FAS) - (06/04)

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