015700222-7-22-2021-52-CC-RRED-C56PPZ-20210722113023

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700222
Report Date: 07/22/2021
Date Signed: 07/22/2021 11:30:36 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:	SINGH, TVAPRAKASH		FACILITY NUMBER:	015700222
ADMINISTRATOR:	SINGH, TVAPRAKASH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 706-7570
CITY:	DUBLIN	STATE: CA	ZIP CODE:	94568
CAPACITY:	14	CENSUS: 1	DATE:	07/22/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Tvaprakash Singh		TIME COMPLETED:	12:00 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	Licensing Program Analyst (LPA) Renee Reed, met with Tvaaprakash Singh on 07/2022021 at approximately 9:30 AM for an ANNOUNCED PRE LICENSING INSPECTION. Present during the inspection were applicant, fingerprint cleared husband Devin Daniels. Also present was 15 & 16 year old sons 11 year old daughter and infant niece. LPA and applicant toured the home to conduct a Health and Safety Inspection. The facility plans to operate 7:00AM 6:00PM, Monday through Friday. Description of Home: The residence is a 2 story which consist of 4 bedrooms, 2 1/2 bathrooms, living room, family room, kitchen backyard and garage. The home has central heat and air. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS entire 2nd floor which will be inaccessible by a safety gate, closed and/or locked doors as well as, visual supervision. The ON LIMIT AREAS are the living room family room converted to day care room and kitchen which is located to the left side of home, the 1/2 bathroom located on the ride side of the home, as well as the backyard. The ISOLATION AREA: will be an area within the living room/day care room. There are ample age appropriate toys that are clean, in good condition and available for childrens usage. 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 today. There is a fireplace which is screened to prevent access by children in care. There are multiple working smoke detectors and carbon monoxide detectors present. See 809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee Reed	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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: SINGH, TVAPRAKASH	FACILITY NUMBER: 015700222
	VISIT DATE: 07/22/2021

NARRATIVE

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The facility has a fully charged 3A10BC fire extinguisher,.two pull down fire alarms, working telephone, and fully stocked First Aid Kit. A fire clearance was granted on 4/2/2021 by the Dublin Fire Prevention Services noting (2nd FLOOR & GARAGE OFF LIMITS TO CHILDREN).

There are age appropriate furnishings, toys, equipment and cots in the day care rooms. The bathroom has a working toilet and faucet in new condition. Per applicant, there are no firearms located or stored on the premises. The home has deck leading to a fully fenced (chain link and wood back yard area, there is a small rocked slope, 100 percent visual supervision will be required in. There is a mud kitchen in the backyard, with a small bowl and a jug of water. LPA advised applicant after play the bowl should to be emptied and turned over after play. The side gate has a lock and not reachable to children There are no pools, hot tubs or other accessible bodies of water.

Hazardous items/cleaning supplies are stored inaccessible to children in care. All electrical outlets are safety outlets. The applicant’s Health and Safety training is completed and CPR and First Aid certificate is current and expires on 002/22/2023. Mandated Reporter is current and expires on 3/10/2023. The applicant is in compliance with the immunization law which pertains to day care providers. There is a fireplace in the home which is covered by a screen and zip tied. Per applicant, there are no firearms in the home. A copy of the rental agreement shows control of property to applicant and spouse Devin Daniels. A packet of forms pertaining to the children’s files and facility files were reviewed and discussed.

Individual Medical Services (IMS) policy was discussed. IMS services will not be provided. at this time. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Home 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.

See 809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee Reed	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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: SINGH, TVAPRAKASH	FACILITY NUMBER: 015700222
	VISIT DATE: 07/22/2021

NARRATIVE

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Applicant 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. Applicant was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

LPA, Reed reminded the applicant of the following; Mandated Reporter training is to be renewed every two years; CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. LPA discussed Unusual Incidents Reports.

The applicant is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

LPA Reed provided a copy of Safe Sleep-in Child-Care brochure, a handout "What Does A Safe Sleep Environment Look Like?" and a copy of the new California Car Seat Law Changes.

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

This home is recommended for Licensure on 7/22/2021. A copy of this report was issued to licensee and is to remain in the facility records for a period of three years. A Notice of Site Visit was also provided and to be posted for 30 days.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee Reed	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

LIC809 (FAS) - (06/04)

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