013421968-6-5-2019-52-CC-LDYN-BCUPMM-20190605112633

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421968
Report Date: 06/05/2019
Date Signed: 06/05/2019 11:26:39 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:	MAHARJAN, BASANTI		FACILITY NUMBER:	013421968
ADMINISTRATOR:	MAHARJAN, BASANTI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 282-6653
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	14	CENSUS: 10	DATE:	06/05/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Basanti Maharjan		TIME COMPLETED:	11:35 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 6/5/19 at 9:45am, Licensing Program Analyst (LPA) Loretta Dyson arrived at the home for an unannounced random inspection. LPA met with the licensee. The licensee's fingerprint cleared husband, 1 infant, and 9 preschool age children were also present. At 10:05am, LPA began an inspection of the areas used for the child care, which include the covered patio, two rooms directly off the patio, a bathroom in rear room, and the backyard. There is a gate separating the child care rooms and the backyard, so the licensee is able to direct children from one area to another. The main home is off limits to children and is made inaccessible by closed and/or locked doors and visual supervision. The isolation area will be a section of the child care room near the bathroom, away from other children in care. The outdoor play area is the fenced backyard, which is free from defects or dangerous conditions. There is sufficient cushioning under the play structure to absorb a fall. LPA tested the smoke detector and carbon monoxide detector, and verified that both are functioning. There is a fully charged 3A40BC fire extinguisher, telephone, and first aid kits. There are no heaters or fireplace accessible to children. LPA did not observe any bodies of water, hazardous items or toxins accessible to children today. There are an ample supply of toys and activities available for children, and they are age appropriate and appear to be in good condition. Per the licensee, there are no firearms in the home. The licensee's CPR/first aid certificate expired in April 2019, but the licensee's husband/assistant has a current CPR/first aid certificate, which expires on 11/3/20. The licensee conducts and documents fire and disaster drills at least twice a year, and the last drills were conducted on 3/22/19. The facility is in ratio today. All required forms are posted and visible for public review. LPA reviewed and obtained a copy of the facility roster. At 10:37am, LPA requested and reviewed the files of 3 children in care. The licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to sign up to receive quarterly updates by email by sending a request to ChildCareAdvocatesProgram@dss.ca.gov. continued on 809C

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

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: MAHARJAN, BASANTI	FACILITY NUMBER: 013421968
	VISIT DATE: 06/05/2019

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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. The licensee stated that there are no children enrolled at this time, who require medication while in care.

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. LPA reviewed the individuals associated to the license, and the licensee confirmed that everyone who is required to have a criminal record clearance is associated. Licensee was reminded of the responsibility as a mandated reporter. The licensee provided proof that she completed the required mandated reporter training on 3/31/18.

The Licensee was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet and LPA discussed safe sleep practices and policy.

There are no deficiencies being cited today. This report shall remain on file for 3 years. A Notice of Site visit was given to Licensee, and Licensee was reminded that it is required to be posted for 30 days. An exit interview was conducted with the licensee.

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

LIC809 (FAS) - (06/04)

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