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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423385
Report Date: 08/03/2022
Date Signed: 08/03/2022 12:48:30 PM


Document Has Been Signed on 08/03/2022 12:48 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:BADEPALLI, HARITHAFACILITY NUMBER:
013423385
ADMINISTRATOR:HARITHA BADEPALLIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 307-8496
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:14CENSUS: 11DATE:
08/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:47 AM
MET WITH:Haritha Badepalli- LicenseeTIME COMPLETED:
12:55 PM
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On 8/3/22 at 11:47am, Licensing Program Analyst Briana Plumboy, met with licensee Haritha Badepalli for an UNANNOUNCED REQUIRED ANNUAL INSPECTION. Present for this visit was licensee's fingerprint clear and associated husband/assistant Satish Badapalli, 2 infants, 6 preschool age children, and 3 school age children (2 which are licensees children). The home was toured to conduct a Health and Safety Inspection. Per the fire clearance, "The above facility has been approved. There is no use of any bedrooms, the study room or the garage." The facility currently operates from 8:30am until 6:00pm.

The home is single story. The home consists of a kitchen, living room, family room, 3 bedrooms, 1 hallway bathroom, a master bedroom and bathroom, garage, and backyard. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the kitchen, ALL bedrooms, a master bedroom with a master bathroom, the left and right side of the backyard, and the garage which will be inaccessible by closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the living room, family room, hallway bathroom, and center area of the backyard. The ISOLATION AREA will be the living room. There is a safety gate located between the living room and kitchen, as well as across the door which leads to the garage. Outdoor play area will be located inside the backyard. The backyard is fenced. The backyard has a swingset and per licensee at this time the swings are not in use. The licensee is aware there must be sufficient cushioning to absorb a fall underneath the swingset if she uses it again for the children in care. Licensee is aware any play equipment must meet manufacture instructions, CCLD regulations, and be in proper condition per manufacture prior to and while being used. There are toys and learning materials. 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 to children in care.
The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The licensees CPR and First Aid certificate is currently expired, and her husbands is current and expires 10/30/23. Licensee is aware her husband must be present during operational hours until she receives a new CPR/First Aid certificate. Per licensee, she is looking to enroll in a class. The licensee's mandated reporter training is complete and she received a certification of completion on 08/08/21. The licensee and her husband are in compliance with the immunization law which pertains to childcare See 809-C for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/03/2022
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: BADEPALLI, HARITHA
FACILITY NUMBER: 013423385
VISIT DATE: 08/03/2022
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providers. The fireplace is located inside the family room and is screened and barricaded to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills more than twice a year with the last earthquake conducted on 07/05/22 and the last fire drill conducted on 07/19/22. LPA Plumboy reviewed licensee's roster and the licensee is in ratio today. All REQUIRED forms are posted and visible for public review.

Incidental Medical Services (IMS) policy was discussed. 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 Haritha Badepalli 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 Haritha Badepalli 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 Haritha Badepalli .

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022
LIC809 (FAS) - (06/04)
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