073405578-2-19-2020-02-CC-LCHW-BLXL4L-20200219072543

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073405578
Report Date: 02/13/2020
Date Signed: 02/19/2020 07:25:49 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:	HAQ, MAMOONA		FACILITY NUMBER:	073405578
ADMINISTRATOR:	HAQ, MAMOONA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 683-1098
CITY:	DANVILLE	STATE: CA	ZIP CODE:	94506
CAPACITY:	14	CENSUS: 10	DATE:	02/13/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:13 AM
MET WITH:	HAQ, MAMOONA		TIME COMPLETED:	01:20 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) LaKeisha Chew conducted an unannounced Annual Random inspection to ensure the health & safety standards as required by regulations governing family childcare homes. Licensee guided LPA on a tour of home that is utilized for childcare. Present during today inspection was licensee fingerprint cleared assistant, Rehana Tariq and ten (10) preschool-age children in care. The licensee is operating within the licensed capacity. LPA reminded licensee if no assistant is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home. Licensee stated three adults (Licensee, her husband and adult son) reside in the home. Per licensee, operating hours are from 09:00 AM - 4:00 PM, Monday thru Friday. Mandatory forms were posted in the entryway of family room (classroom) for public view. Licensee has a current roster of the children in care available for review and a copy was obtained during today's inspection. This is a single three (3)-bed, three (3)-bathroom home. On limits area consist of the family room (classroom), kitchen, bathroom located in the hallway, master bedroom (napping), and fenced backyard. The remainder of the home is off limits which consists of the living room, dining room, two (2) bedrooms, master bathroom, laundry room, garage and bathroom inside garage which is made inaccessible by closed and/or locked doors, and visual supervision. The home met regulations with heating and ventilation for safety and comfort. The outdoor play area is a fenced backyard, which is free of hazards. The home has a fountain in the fenced backyard, that is filled with rocks and pine needles. There are no bodies of water at this home. There are no firearms on the premises as stated by the licensee. Detergents, cleaning compounds and medications are stored in laundry room which is an off-limits area of home and inaccessible to children. The screened glass fireplace located in the family room is securely barricaded to prevent access by children. LPA verified the home is equipped with a fully charged 3A40BC fire extinguisher. The home has a working smoke detector, carbon monoxide detector, and telephone in the home. LPA observed a fully stocked First Aid Kit. Per licensee, last fire safety drill was conducted on 02/11/2020. There were no pets present in the home.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Lakeisha Chew	TELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

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: HAQ, MAMOONA	FACILITY NUMBER: 073405578
	VISIT DATE: 02/13/2020

NARRATIVE

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LPA observed the home has cabinet slide locks. The licensee has completed the required training on preventive health practices including pediatric CPR and First Aid which expires on 10/27/2020 and assistant expires on 10/06/2021.

Licensee was reminded that anyone working, residing or frequently visiting the home must be fingerprint cleared prior to being in the presence of children or an immediate civil penalty can be assessed. (LPA reminded licensee that all adults residing in the home must have criminal record/TB clearances).

Children’s records were reviewed and found to be complete during today's inspection.

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

The licensee was also encouraged to email ChildCareAdvocatesProgram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

No deficiencies cited today.

Exit interview conducted.

Licensee was provided a copy of their appeal rights.

Notice of site visit was posted at the time of the inspection and must remain posted for 30 days.

Failure to keep this notice posted for the 30 consecutive days will result in an immediate civil penalty.

A copy of this report shall be maintained for 3 years and available for public review upon request.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Lakeisha Chew	TELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

LIC809 (FAS) - (06/04)

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