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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422083
Report Date: 07/15/2021
Date Signed: 07/15/2021 11:22:00 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:SINGH, RENUFACILITY NUMBER:
013422083
ADMINISTRATOR:SINGH, RENUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 431-8736
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:14CENSUS: 0DATE:
07/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Renu SinghTIME COMPLETED:
11:45 AM
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Licensing Program Analysts, (LPA), Renee Reed met with Licensee Renu Singh on 7/15/2021 at approximately 9:15 AM for an UNANNOUNCED 1 YEAR REQUIRED INSPECTION. Present during this inspection was Licensee and 16 year old daughter. Licensee is currently closed until August 16, 2021. The facility currently operates 8:45 AM to 3:45 PM., Monday through Friday. LPA and Licensee toured the home to conduct a Health and Safety Inspection.

The home is neat and clean with heating and ventilation for safety and comfort.

Description of Home: The residence is a two story, which consist of 5 bedrooms, 4 1/2 bathrooms, living room, dining room, family room, in-law suite(converted to day care rooms, kitchen, loft, laundry room and attached garage.

On Limit Areas are the living room, dining room, family room kitchen, bathroom, in-law-suite converted to day care rooms, backyard. Off limits entire upstairs of home and garage. The off-limit areas will be inaccessible by child safety gates, closed and/or locked doors and visual supervision. Isolation Area is the front dining room. There are multiple smoke detectors and a carbon monoxide detector present and working during inspection. The facility has a fully charged 2A10BC fire extinguisher.

During Inspection LPA observed all required posting are present and in a prominent area for public view. Licensee closed March of 2020 to February of 2021, briefly reopened from March 2021 to May 2021. Last Fire and disaster drills was logged 4/16/2021. LPA observed that all poisons, detergents, cleaning compounds, and medication are inaccessible to children. There are no bodies of water such as pools, hot tubs, or similar bodies of water accessible to children.



See 809-C
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee ReedTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
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: SINGH, RENU
FACILITY NUMBER: 013422083
VISIT DATE: 07/15/2021
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There are ample age appropriate toys, furnishing, toys and equipment in safe and good condition in the play rooms, as well as cots for napping. The bathroom has working toilet and faucet in good working condition

LPA observed a fireplace in the family room which is screened. Licensee indicated the children will only walk through the kitchen and family room to enter the backyard. Outdoor play area is completely fenced and free from defects or dangerous conditions. There is an ample supply of toys and activities available for children, and they are in good condition and age appropriate in the backyard.

Licensee reviewed 2 children files who recently left facility on 5/29/2021 and files were complete.

Licensees CPR and First Aid is current and expires 3/20/2023. Mandated Reporter has not been completed, last inspection was done July 30, 2017. LPA provided Licensee with the mandatedreporterca.com website to complete the general and child care provider training. Licensee will complete course and send a copy of certificate by email once complete, by next week. Licensee is following immunization laws which pertains to all day care providers. Per Licensee there are no firearms in home.

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. LPA discussed Unusual Incidents Reports.

The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing.



The licensee was 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. The licensee was reminded of the responsibility as a mandated reporter.

See 809-C
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee ReedTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
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: SINGH, RENU
FACILITY NUMBER: 013422083
VISIT DATE: 07/15/2021
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The 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. The licensee was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet.

There are no deficiencies cited. This report shall remain on file for 3 years. A Notice of Site visit was given to Licensee and is required to be posted for 30 days. Exit interview conducted.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee ReedTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3