013422793-1-6-2020-52-CC-JWIS-BKKPZG-20200106104531

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422793
Report Date: 01/06/2020
Date Signed: 01/06/2020 10:45:39 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:	KRISHNAKUMAAR, JANANI		FACILITY NUMBER:	013422793
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	01/06/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Janani Krishnakumaar		TIME COMPLETED:	11:00 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 01/06/2019, Licensing Program Analysts (LPA) Jonathan Williams and Manel Estoesta and Licensing Program Manager (LPM) Wynn Norona met with licensee Janani Krishnakumaar for a CASE MANAGEMENT VISIT - INCREASE IN CAPACITY. Present for this inspection was five children in care (two infants and three preschoolers) and fingerprint cleared assistant provider. The facility was toured to conduct a Health and Safety Inspection for capacity change. The home is a two-story Family Child Care Home. The home is tidy and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the kitchen, family room, one bedroom, one bathroom, the backyard, and the newly converted garage. The OFF LIMIT AREAS are the living room, the dining room, and the entire second floor which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be the nap room. The outdoor play area is age-appropriate and free of defects/dangerous conditions. There are ample age appropriate toys that appear to be safe, and in good condition. There are no pools, hot tubs, ponds, or any other bodies of water. All hazardous materials and toxins were observed to be made inaccessible to children. Fire clearance was approved 12/18/2019. The home has two fully charged 3A40BC fire extinguishers, working smoke detector, working carbon monoxide detector, working telephone, and fully stocked first aid kit. The licensee CPR and first aid certificate is current and expires 10/21/2020. Licensee completed the Mandated Reporter Training which expires on 02/10/2020. Licensee has current immunization records on file. The fireplace is made inaccessible to children because it is located in an off limits area. Per licensee, there are no firearms in the home.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan Williams	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020

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: KRISHNAKUMAAR, JANANI	FACILITY NUMBER: 013422793
	VISIT DATE: 01/06/2020

NARRATIVE

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The licensee conducts and documents fire and disaster drills at least every six months.

Children’s files and facility roster were reviewed, and copies of each were obtained. The licensee is in ratio today. All required forms are posted and visible for public review.

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 fingerprinted, obtain a criminal record clearance, and associated to this facility prior to being in the presence of children in care. Licensee was reminded that any failure to comply with these regulations will result in an immediate assessment of civil penalties of $100 to $3000 per person, per incident.

Incidental Medical Services (IMS) policy was discussed. 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

There are no deficiencies cited. This report shall remain on file for 3 years. A Notice of Site Visit was provided to the licensee and LPAs/LPM reminded the licensee to post the Notice of Site visit where it is clearly visible inside the facility for 30 days. Exit interview was conducted and appeal rights provided

Effective today, January 06, 2019, this home is licensed for a large Family Child Care Home.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan Williams	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020

LIC809 (FAS) - (06/04)

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