013421965-7-20-2022-52-CC-KPHN-CGHP3A-20220720105712

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421965
Report Date: 07/20/2022
Date Signed: 07/20/2022 10:57:19 AM

Document Has Been Signed on 07/20/2022 10:57 AM - It Cannot Be Edited

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:	TANGIRALA, SWAPNA		FACILITY NUMBER:	013421965
ADMINISTRATOR:	TANGIRALA, SWAPNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 358-5672
CITY:	FREMONT	STATE: CA	ZIP CODE:	94538
CAPACITY:	14	CENSUS: 6	DATE:	07/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Swapna Tangirala		TIME COMPLETED:	11:10 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 07/20/2022 approximately at 9:00AM Licensing Program Analyst (LPA) Kelly Phan arrived at for an unannounced required inspection, and met with Licensee Swapna Tangirala. Present for this inspection was the licensee, licensee's fingerprinted and associated sister/helper along with 6 preschool aged children. Also residing in the home is the licensee's fingerprinted husband and their 14 years old son. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 9:00am to 6:00pm. ON LIMITS: bedroom #1 that is closest to the kitchen (isolation area), bathroom #1 in the family room, fenced backyard, living room, and family play room OFF LIMITS: garage, kitchen, bedroom #2, bedroom #3, and bedroom #4, left and right side yards. Off limit areas are inaccessible by closed and/or locked doors, and visual supervision. The home is single story, which is neat and clean, with heating and ventilation for safety and comfort. At 9:05AM, LPA observed there were ample age appropriate toys and activities that were observed to be safe and in good condition. Per licensee, there is a double swing in the backyard that is broken and is not able to find the proper screw for it; she states that she always maintain supervision to ensure children are not playing on to ensure their safety. There were no toxins, medicines, and hazardous items were inaccessible during today's inspection. The pathway to the bathroom in the family play room has a sliding door that prevents children from accessing washer and dryer and per licensee she always supervise them on their pathway to the bathroom. There were a fully charged 3A40BC fire extinguisher, working carbon monoxide, smoke detectors, and telephone. The home does not have a fireplace; per licensee the home has central heating. Per licensee, there are no firearms or pets or any bodies of water in the home. The licensee conducts and documents fire drill log indicates a drill was conducted 05/01/22. All required licensing documents are posted and visible for public review in the family play room. SEE LIC 809 C

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Kelly Phan	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022

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 3

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: TANGIRALA, SWAPNA	FACILITY NUMBER: 013421965
	VISIT DATE: 07/20/2022

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

At 10:00am, 6 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. Licensee and her sister/helper has proof of the required immunization. The licensee and her sister/helper have required mandated reporter training that is completed as of 04/29/2021. Both licensee and her sister/helper has CPR and First Aid training that is valid until 03/14/2023.

There were no deficiencies were cited for today's inspection

Appeal rights and a notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.00. Exit interview conducted and report was reviewed with licensee Swapna Tangirala

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.

Incidental Medical Services (IMS) policy was discussed. This facility does not provides IMS to children in care. 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.”

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Kelly Phan	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: TANGIRALA, SWAPNA	FACILITY NUMBER: 013421965
	VISIT DATE: 07/20/2022

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

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Licensee was reminded that California Law requires licensed Child Care Centers to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the Facility Representative that all forms can be downloaded at www.ccld.ca.gov and encouraged the Facility Representative to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. Licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Kelly Phan	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3