013423369-9-3-2021-52-CC-BPLY-C6HNHT-20210903102913

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423369
Report Date: 08/31/2021
Date Signed: 09/03/2021 10:29:34 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:	BADAM, HARIKA		FACILITY NUMBER:	013423369
ADMINISTRATOR:	HARIKA BADAM		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(812) 361-7599
CITY:	UNION CITY	STATE: CA	ZIP CODE:	94587
CAPACITY:	14	CENSUS: 12	DATE:	08/31/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:53 PM
MET WITH:	Harika Badam		TIME COMPLETED:	03:50 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	On 08/31/21 at 2:53pm, Licensing Program Analyst Briana Plumboy met with licensee Harika Badam for an UNANNOUNCED REQUIRED ANNUAL INSPECTION. Present for this visit was 3 infants, 8 preschool age children, and 1 school age child (licensees daughter). Also present is licensee's fingerprint clear and associated assistant Harjot Kaur and fingerprint clear and associated husband Harish Gokavarapu. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 8:30am until 5:30pm. The home is two levels. The home consists of a living room, kitchen, dining room, family room, a sun room, an outside storage room, 2 bathrooms, 3 bedrooms, a master bedroom with a master bathroom, and a garage. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the storage room located on the left side of the backyard, the entire second level of the home, and the garage which will be inaccessible by closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the living room, dining room, family room, kitchen, sun room, and downstairs bathroom. As of 8/31/21, the left side and base section of the backyard is included in the on limit areas. Per the fire clearance which was approved on 12/02/19 by the Union City Fire Department, Fire clearance approved for use of first floor ONLY. No Daycare activity allowed on second floor or in the garage at anytime. The ISOLATION AREA will be the living room. There is a gate located at the bottom of the stairs. There is also a gate located between the family room, living room, and kitchen. Outdoor play area will be in the front yard and the backyard. The licensee is aware there must be 100% visual supervision at all times in the front yard. There is an anchored swing set located in the backyard. Licensee is aware the backyard must remain free from hazards at all times. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible to children in care during today's inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, pull down fire alarm, working carbon monoxide detector, and working telephone. The licensee's CPR and First Aid certificate is current and expires 06/12/23. The licensee's mandated reporter training is complete and she received a certification of completion on 06/10/21, and assistant Harjot Kaur's employee file is complete and she received a certificate of completion in mandated reporter training on 06/10/21. The See 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021

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: BADAM, HARIKA	FACILITY NUMBER: 013423369
	VISIT DATE: 08/31/2021

NARRATIVE

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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

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, 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

LPA discussed the safe sleep regulations with licensee Harika Badam and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Harika Badam of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days.

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Harika Badam.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021

LIC809 (FAS) - (06/04)

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