013422377-10-17-2019-02-CC-CCON-BH2QYP-20191017123527

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422377
Report Date: 10/17/2019
Date Signed: 10/17/2019 12:35:32 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	DIKI, SONAM		FACILITY NUMBER:	013422377
ADMINISTRATOR:	DIKI, SONAM		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 374-9894
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94602
CAPACITY:	14	CENSUS: 5	DATE:	10/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Sonam Diki		TIME COMPLETED:	12:50 PM

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	Licensing Program Analyst Caroline Colson met with Sonam Diki, her sister and assistant, Fnu Dickey, and her mother in law, Fnu Bhakdo and her adult daughter, Tensin Diki for unannounced random annual inspection at 11:20 AM. One (1) child's record was reviewed by the LPA and the licensee on 10/17/19 at 12:15 PM. C1 has a complete file. There are four (4) infants and one (1) preschool child present. The home was toured to conduct a health and safety inspection. The home is a two story home. The home consists of a living room, dinning room, kitchen with eating area, 2 upstairs bedrooms, 2 downstairs bedrooms, 1 upstairs bathroom, 1 downstairs bathroom, an upstairs hallway closet, fenced front yard, fenced back yard and garage. There is a 2A10BC fire extinguisher, working combination smoke and carbon monoxide detector. The off limit areas is one (1) upstairs bedroom, the upstairs bathroom, kitchen, living room, dinning room, garage and fenced front yard. The one (1) upstairs bedroom is used for napping. The isolation area is a separate area in the downstairs bedroom which is also the play room. Mrs. Diki states that there are no firearms in the home. She has no pets. Mrs. Diki has current pediatric CPR and First Aid certificates which expire on July 21, 2021. She has a First Aid Kit available. This facility is not providing Incidental Medical Services-IMS at this time. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family child care home evaluator manual (FCCH EM) Policy 102417. See LIC 809 C for additional information.

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

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 2

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: DIKI, SONAM	FACILITY NUMBER: 013422377
	VISIT DATE: 10/17/2019

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

REMINDERS/RESOURCES

· Criminal Background Clearance: All assistants, volunteers, frequent adult visitors (adults are individuals 18 years of age or older) must be fingerprint cleared and associated to the facility prior to be in the presence of children in care. Failure to comply, requires an immediate civil penalty of $100 to $3000 per person, per incident.

· CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

· NEW LAW: Safe Sleep Regulations: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

· Licensees and all staff are Mandated Reporters and are required to report to CCLD any suspected child abuse.

CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov

· Licensees may register to receive child care updates: www.myccl.ca.gov

The childcareadvocatesprogram@dss.ca.gov is the email address for the applicant to sign up to receive PINS.

A site notice was posted. An exit interview was conducted. Appeal rights were discussed and given. This report must remain available for public review for 3 years.

There were no deficiencies cited during this inspection.

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2