013420760-8-17-2021-52-CC-RHAR-C5YVPE-20210817163639

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013420760
Report Date: 08/17/2021
Date Signed: 08/17/2021 04:36:59 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:	MUJRAL, ANUPAMA		FACILITY NUMBER:	013420760
ADMINISTRATOR:	MUJRAL, ANUPAMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 896-8656
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY:	14	CENSUS: 11	DATE:	08/17/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Anupama Murjal		TIME COMPLETED:	04:40 PM

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On August 17, 2021 at approximately 2:45pm Licensing Program Analyst (LPA) Russ Haderer met with licensee Anupama Mujral for the purpose of conducting an unannounced 1-year annual inspection for Health and Safety compliance. Present for today’s inspection was the licensee, her TB and fingerprint cleared assistants Chandrawati and Shabnam Syed and her adult son. There were 11 children in care (three infants, four 2-years; four 3-years old). The hours of operation will be Monday-Friday, 8:00 AM to 6:00PM.

The facility is a single story 4-bedroom, 3 bath home with an attached 2-car garage. It is owned by the licensee and contains a large foyer in entrance area, dining room, family room, living room (with a gas fireplace with covering) kitchen, dedicated daycare room in the back, enclosed (fenced) side and backyard areas. The home is neat and clean with heating and ventilation for safety and comfort. Per the licensee, the ISOLATION AREA will be in the bedroom/office near the daycare room away from the other children in care.

On-limit-areas include: Children’s daycare area in the back of the house (includes a small kitchenette), with an attached children’s bathroom, side yard (entrance for daycare) and main backyard area used for play. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area.

Off-limit-areas include: The all four bedrooms, 2 main house bathrooms, the dining room, kitchen, foyer area and attached 2-car garage and north side yard of the house. The off-limit area will be inaccessible by closed and/or locked doors, and/or by child supervision.

Disaster drills are conducted every couple of months, the last one was done June 14, 2021. Per licensee, there are no firearms in the home. There is a small water feature (fountain) in the backyard play area. Licensee reminded that this must always be kept empty of water. LPA did not observe any hazardous materials, or toxins accessible to children on the premises during the inspection.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021

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: MUJRAL, ANUPAMA	FACILITY NUMBER: 013420760
	VISIT DATE: 08/17/2021

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At 3:45pm, LPA reviewed facility files including records for licensee and assistants and the Children’s files. All files were complete and well organized.

Licensee has ample age-appropriate toys and learning materials. The home has a fully charged 3A40BC fire extinguisher stored in children’s bathroom in the daycare room. There is a working telephone, a smoke detector and carbon monoxide detector (tested and functioning). The licensee’s Health and Safety training is completed, and CPR and First Aid certificates are current and expire 06/08/2022. Mandated Reporter certificate is current and expires 6/21/2022. Assistants Mandated Reporter expires 9/17/2022 (Chandrawati) 7/19/2023 (Shabnam). CPR for Chandrawati is current and expires 2-8-2022. Licensee and assistants are in compliance with the immunization laws which pertains to day care providers.

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.

Licensee carries liability insurance through Acord, the policy is current though 6/17/2022.

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 reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information 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

Child files were reviewed, roster was available for all years of operation.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021

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: MUJRAL, ANUPAMA	FACILITY NUMBER: 013420760
	VISIT DATE: 08/17/2021

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For licensing updates email childcareadvocatesprogram@dss.ca.gov and advised to be added to the email list.

LPA discussed new safe sleep requirements for infants and left a copy of the new Title 22 102425 regulation which pertains to this.

There were no deficiencies issued during today’s inspection: This report will remain on file for 3 years.

An exit interview was conducted, and a Notice of Site Visit was posted at time of inspection and must remain posted for 30 days

A review of operating safely during the Covid-19 pandemic (RAST) was conducted.

Exit interview was conducted with licensee, LPA left the home at 4:40 pm.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021

LIC809 (FAS) - (06/04)

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