073404585-1-29-2020-02-CC-GRED-BLAVDG-20200129152041

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073404585
Report Date: 01/29/2020
Date Signed: 01/29/2020 03:21:10 PM

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:	CHHABRA, BENU		FACILITY NUMBER:	073404585
ADMINISTRATOR:	CHHABRA, BENU		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 825-7916
CITY:	CONCORD	STATE: CA	ZIP CODE:	94521
CAPACITY:	14	CENSUS: 10	DATE:	01/29/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	CHHABRA, BENU, 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	Licensing Program Analyst (LPA) Redmond, arrived at the facility on 01/29/20 at 1:45 PM to conduct a health and safety inspection. The purpose of the inspection is to ensure the Licensee is in compliance with Title 22, CCR and Health and Safety Code Statutes. During the inspection, LPA met with CHHABRA, BENU, Licensee. LPA inspected all areas of the facility which are accessible to children. LPA made the following observations during the inspection: Capacity/Staffing: The facility operates as a Family Day Care (large), with a maximum capacity of fourteen (14) children. On this date, there are ten (10) children in care. The Licensee, and one staff person present. The facility is in compliance with capacity limitations, child ratios and staffing levels. Posted as required: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist. If You See Something, Say Something. Physical Plant: Overall, the facility is clean, orderly and in good repair. The temperature is comfortable and there is adequate heating and ventilation. There are safe, healthful and comfortable accommodations, furnishings and equipment. There are no cleaning solutions, medications, toxins or other hazardous items accessible to children. There are no pools, hot tubs or other bodies of water present. Emergency Preparedness/Safety: LPA observed a smoke detector, which was tested and found operable. LPA observed a carbon monoxide detector. LPA did not test because the children are sleeping. There is a fully charged fire extinguisher, with a classification code of CONTINUED

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020

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: CHHABRA, BENU	FACILITY NUMBER: 073404585
	VISIT DATE: 01/29/2020

NARRATIVE

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code of (2-A:10-B:C), which, meets fire marshal requirements. First aid supplies available. Emergency Disaster Plan is current, per Licensee. Fire and earthquake drills were conducted on 12/23/19 and meet six (6) month requirement. The facility utilizes a land line telephone. Per the Licensee, there are no firearms present. The Licensee is not currently providing *Incidental Medical Services (IMS) for children in care.

Training/Record Review:

LPA reviewed some facility files at 2:15 PM. Licensee, and all adults residing in the home have criminal background clearances and are associated to the facility. Licensee and has current CPR/First Aid training. Licensee has completed Mandated Reporter training, which was taken on 08/07/19. Licensee provides care for infants. LPA discussed Safe Sleep requirements with Licensee and staff. Licensee has proper infant sleep devices available. More information on Safe Sleep can be found at: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep. Forms and training videos can be obtained on the CCLD website: www.ccld.ca.gov

NO DEFICIENCIES CITED ON THIS DATE

Exit interview conducted: This Facility Evaluation Report was issued to and discussed with the Licensee. Signature obtained. A copy of this report shall be maintained for 3 years and available for public review upon request. Additional reminders and resources provided on next page.

Notice of Site Visit: was issued and shall be posted remain posted for 30 days. Failure to keep this notice posted for the 30 consecutive days will result in an immediate $100 civil penalty.

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020

LIC809 (FAS) - (06/04)

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