013423369-8-29-2024-52-CC-BPLY-D8LTBB-20240829143452

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423369
Report Date: 08/29/2024
Date Signed: 08/29/2024 02:35:00 PM

Document Has Been Signed on 08/29/2024 02:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 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: 10	DATE:	08/29/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:53 PM
MET WITH:	Harika Badam- Licensee		TIME COMPLETED:	03:00 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 08/29/24 at approximately 1:53pm, Licensing Program Analyst Briana Plumboy met with licensee Harika Badam for an UNANNOUNCED REQUIRED ANNUAL INSPECTION. Present for this visit was 4 infants, 6 preschool age children, fingerprint clear and associated assistant Bhupinder Hothi, and licensees fingerprint clear and associated husband Harish Gokavarapu. The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday through Friday, 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 kitchen, 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, sun room, and downstairs bathroom. 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 which is designed for 3- 10 year olds. Licensee is aware the backyard must remain free from hazards at all times. 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 and assistant present during today's inspection are both in compliance with the immunization law. The licensee's CPR and First Aid certificate is current and expires 06/3/25. The licensee's mandated reporter training is complete and she received a certification of completion on 5/23/23, and assistant Bhupinder Hothi's file is complete and she received a certificate of completion in mandated reporter training. The licensee conducts disaster drills with the last one conducted on 7/9/24. The licensee is documenting safe sleep checks. 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: 08/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: BADAM, HARIKA	FACILITY NUMBER: 013423369
	VISIT DATE: 08/29/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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: 08/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: BADAM, HARIKA	FACILITY NUMBER: 013423369
	VISIT DATE: 08/29/2024

NARRATIVE

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Licensee Harika Badam is aware she should have knowledge of all Title 22 Regulations and follow all Title 22 Regulations at all times, as well as follow manufacture guidelines for all equipment in the facility.

The licensee provided proof of control of property.

LPA discussed the safe sleep regulations with and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed licensee 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.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility.

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: 08/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

LIC809 (FAS) - (06/04)

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