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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422797
Report Date: 12/06/2019
Date Signed: 12/06/2019 03:19:04 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:PATEL GANDHI, SANGITABENFACILITY NUMBER:
013422797
ADMINISTRATOR:PATEL GANDHI, SANGITABENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 305-4458
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:14CENSUS: 2DATE:
12/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Sangitaben Patel GandhiTIME COMPLETED:
03:35 PM
NARRATIVE
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On 12/06/19, Licensing Program Analysts Briana Plumboy and Leslie Ibo, met with licensee Sangitaben Patel Gandhi for an UNANNOUNCED RANDOM INSPECTION. The home was toured to conduct a Health and Safety Inspection. There were two infants in care today. The facility currently operates Monday- Friday from 7:00am until 6:00pm.

The home is two levels. The home consists of a family room, living room, kitchen, garage, 5 bedrooms, a laundry room, and 3.5 bathrooms. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the garage, downstairs master bedroom with bathroom, and the entire second level of the home which will be inaccessible by closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the family room, living room, kitchen, and downstairs bathroom. There is a gate located at the bottom of the stairs to prevent access to children under the age of 5 years old to the second level of the home. The ISOLATION AREA will be the living room. Outdoor play area will be the fenced backyard, and per licensee the children will not play on the left side of the home. There are no pools, hot tubs or any other bodies of water present in the on limit areas during today's inspection. All hazardous materials and toxins are kept out of the reach of children and it was observed that during the inspection there are no toxins or hazardous items accessible.

The home has a fully charged fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The licensee has CPR and First Aid with expiration date 07/24/21. The licensee received a certificate of completion in mandated reporting on 09/21/19. The licensee is in compliance with the immunization law. The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home.
Today the following deficiencies were observed:
1. Upon arrival LPA’s observed C2 was sleeping on the rocker.
2. There was a baby walker on the on limit area.
See 809-C AND 809-D for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2019
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: PATEL GANDHI, SANGITABEN
FACILITY NUMBER: 013422797
VISIT DATE: 12/06/2019
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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

LPA Plumboy provided a copy of Safe Sleep in Child Care brochure, a handout "What Does A Safe Sleep Environment Look Like?," and PIN 19-06-CCP to the licensee

The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility.
California Law requires Family Child Care Home licensees 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.

Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day 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. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.



See LIC809-D for deficiencies. Appeal rights provided. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2019
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: PATEL GANDHI, SANGITABEN
FACILITY NUMBER: 013422797
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/06/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/13/2019
Section Cited

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Personal Rights. Each child shall be accorded safe, healthful and comfortable accommodations, furnishing and equipment. LPAS OBSERVED AN INFANT (C2) ASLEEP ON A ROCKER.
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AN INFANT ROCKER IS NOT DESIGNED FOR NAPPING/SLEEPING EQUIPMENT. THE POLICY IS TO REMOVE CHILDREN FROM THE ROCKER ONCE THEY FALL ASLEEP. This poses a potential health risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type B
12/13/2019
Section Cited

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Operation of a Family Child Care Home. A baby walker is not permitted on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).
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This requirement was not met as evidenced by: Based on observation, THERE WAS AN INFANT WALKER OBSERVED IN THE LIVING ROOM WHICH IS ON LIMIT. This poses a potential health risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 12/06/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2019
LIC809 (FAS) - (06/04)
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