013420796-8-29-2023-52-CC-JSAI-CV6U25-20230829151121

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013420796
Report Date: 08/29/2023
Date Signed: 08/29/2023 03:11:32 PM

Document Has Been Signed on 08/29/2023 03:11 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SULTANI, SHARARA		FACILITY NUMBER:	013420796
ADMINISTRATOR:	SULTANI, SHARARA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 386-5727
CITY:	DUBLIN	STATE: CA	ZIP CODE:	94568
CAPACITY:	14	CENSUS: 7	DATE:	08/29/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:05 PM
MET WITH:	Licensee, Sharara Sultani		TIME COMPLETED:	03:40 PM

NARRATIVE

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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee, Sharara Sultani for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during this inspection was Licensee supervising four (4) infants and three (3) preschoolers. The home is a single home with 3 bedrooms including a master bedroom with master bathroom, bathroom #2, living room, family room, kitchen, dining area, laundry room, garage, and back yard.

ON-LIMIT AREAS bedroom #1, bedroom #2, hallway bathroom, kitchen, dining area, living room and family room as(main day care) and backyard. OFF-LIMIT AREAS are the master bedroom and bathroom, laundry room and garage, and off limit inaccessible to children by locked doors, safety gates and visual supervision at all the times.

LPA observed the following: Daycare Area is clean, orderly, and equipped with age-appropriate toys and equipment for children, indoors and outdoors. Home has a working telephone, a working smoke, and a fire extinguisher that meets the minimum requirements. There are no bodies of water or fireplace in the daycare, There are child size tables and chairs for snack and activities. There are ample of age-appropriate toys that appear to be safe and in good condition. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. Licensee was instructed that smoking, baby bouncers, exersaucers, baby walkers and similar items are prohibited in the facility during day care hours. The napping room had cribs in good condition and each child have their separate blankets. The blankets are washed by the provider weekly. Licensee states there are no guns or weapons of any kind in the home.

Licensee's CPR expire in 02/26/2024. Licensee provides daily snacks and meals. Discipline policy is redirection. LPA reviewed children’s files. All required postings are properly posted. The licensee conducts and documents fire and disaster drills twice a year and the last conducted drill was on 06/02/2023.

See next page...

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

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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Document Has Been Signed on 08/29/2023 03:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SULTANI, SHARARA	FACILITY NUMBER: 013420796
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(a)

Staffing Ratio and Capacity

(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. At 12:15pm, LPA observed that licensee was supervising four (4) infants and three (3) preschool children by herself. Although Licensee is licensed for a capacity of 14, the capacity reverts back to a capacity of 8 chilldren if a qualified assistant is not available, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 08/30/2023
	Plan of Correction
1 2 3 4	Licensee to send a written plan to the Department detailing how she will remain in compliance with the limitations of her license regarding capacity and ratio by POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SULTANI, SHARARA	FACILITY NUMBER: 013420796
	VISIT DATE: 08/29/2023

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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

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

Type A deficiency is cited today( Please see attached LIC809-D)
Two technical violations were given.

LICENSEE MUST POST ANY TYPE A DEFICIENCIES DURING TODAYS VISIT WITH THE NOTICE AND LICENSEE UNDERSTANDS THE NOTICE AND TYPE A DEFICIENCIES MUST REMAIN POSTED FOR THIRTY DAYS. REQUIREMENTS FOR AB 633 FACT SHEET AND A COPY OF ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) WERE DISCUSSED WITH PROVIDER. PROVIDER UNDERSTANDS THIS REQUIREMENT.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Sharara Sultani

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

LIC809 (FAS) - (06/04)

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