013423580-4-30-2020-02-CC-ASIH-BP6L92-20200430083248

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423580
Report Date: 04/28/2020
Date Signed: 04/30/2020 08:32:59 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	ALPEROWITZ, CHAYA		FACILITY NUMBER:	013423580
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	04/28/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Chaya Alperowitz		TIME COMPLETED:	02:15 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 04/28/20 at 11:45 AM Licensing Program Analysts (LPA), Arminder Singh conducted an announced Pre-licensing Inspection via Zoom Meeting. LPA had a meeting with the Applicant Chaya Alperowitz. Applicant applied for a CHANGE OF LOCATION from previously licensed address at 2900 San Jose Ave #A Alameda CA 94501 to New Address: 609 Arlington Isle Alameda CA 94501. Adults residing in the home are the Applicant, her Spouse, and four children who are minors. Applicant applied for a Small Family Child Care Home with capacity for 8 children. Days and hours of operation will be Monday through Friday from 8:00 AM - 5:00 PM. Applicant has current Pediatric cardiopulmonary resuscitation (CPR) and First Aid (expires 07/2020) Applicant rents this property and LPA reviewed and obtained a copy of the Rental Agreement during today's inspection. Applicant has a working telephone in the home. At 12:00 PM: LPA toured the indoor space of the home with the Applicant via Zoom Meeting Application. The home is a single story house with Living room, Kitchen, Dining area, Play room, Four (4) Bedrooms, Three (3) Bathrooms, Garage, and Backyard. IN USE AREAS: Living room, Kitchen, Dining area, Bedroom #4, Bathroom located in Bedroom #4, Play Room, and Backyard. OFF LIMIT AREAS: Bedrooms #1-3, Garage, Bathroom located in Master Bedroom, Bathroom located near Bedroom#3, and locked Storage Shed on right side yard. CONTINUED ON NEXT PAGE

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 622-2634
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2020

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ALPEROWITZ, CHAYA	FACILITY NUMBER: 013423580
	VISIT DATE: 04/28/2020

NARRATIVE

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The home is sanitary, safe and orderly, with central heating and ventilation for safety and comfort. LPA observed required Postings on the wall in the Kitchen. There is a non-functional fireplace in the Living Room. LPA observed: fully charged 2A10BC fire extinguisher in the Bathroom, working smoke and carbon monoxide detectors all over the home. Medicines, cleaning products, sharp objects are stored inaccessible to children in cabinets and out of reach of children. A gate is securely installed near the right of the kitchen that prevents children to have access to the off limit areas. LPA reminded Applicants that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. Applicants state there are no pets in the home. Applicant states there are no firearms and ammunition stored in the home.

At 12:45 PM Outdoor Space: Back Yard is fully fenced. Backyard is ON LIMITS and does have a lagoon. Lagoon is inaccessible by the high wooden fence and glass located on the top of the fence that prevents children from reaching or climbing over. LPA reminded that 100% visual supervision is required when children are playing outside.

Applicant understands that children's personal rights should not be violated and no corporal punishment. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries and requirements for assistant/substitute were also discussed. Fire drills must be practiced once every six months and documented.

LPA discussed Individual Medical Services (IMS) policy. Applicant does not plan on providing IMS at this time. 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.

CONTINUED ON NEXT PAGE

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 622-2634
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2020

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ALPEROWITZ, CHAYA	FACILITY NUMBER: 013423580
	VISIT DATE: 04/28/2020

NARRATIVE

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LPA reminded Applicant of the applicable $100 civil penalty per person per day, a minimum of $100.00 to a maximum of $3000.00 per person for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children.

LPA discussed Assembly Bill (AB) 1207 (Mandated Child Abuse Reporting Training) which is required training that began on January 1, 2018 and requires renewal every two years, AB 633 was discussed with Applicants. Licensing forms, Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov. Mandated Reported Training can be accessed at www.mandatedreporterca.com.

Applicant has Safe Sleep Regulation Pamphlet and Lead Poisoning Flyer.

At 1:45 PM Exit interview was conducted with Applicant and LPA over telephone.

This home is recommended for licensing. LPA reminded the applicant that compliance with all Title 22 regulations and applicable Health and Safety regulations, must be maintained at all times.

Applicant signed the report acknowledging receipts of documents.

END OF REPORT

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 622-2634
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2020

LIC809 (FAS) - (06/04)

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