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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407243
Report Date: 10/04/2019
Date Signed: 10/04/2019 11:10:21 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:BANERJEE, ANITAFACILITY NUMBER:
073407243
ADMINISTRATOR:BANERJEE, ANITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 797-2151
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY:14CENSUS: 9DATE:
10/04/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Anita BanerjeeTIME COMPLETED:
11:25 AM
NARRATIVE
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Licensing Program Analyst (LPA) Julia Placencia arrived for an unannounced Annual/Random Inspection, and met with licensee Anita Banerjee. Present during today's inspection were three infants, six preschool age children, and fingerprint cleared helpers Ahriana Rice and Aruna Kanakamedala. Also residing in the home are the licensee's fingerprint cleared spouse, and 17 year old son. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8:00am to 6:00pm.

ON LIMITS: Entire first floor, backyard, garage (per licensee, garage is currently not being used for day care).
OFF LIMITS: Laundry room, entire second floor. Off limit areas are inaccessible by closed and/or locked doors and visual supervision.

The home is two story, which is neat and clean, with heating and ventilation for safety and comfort. The outdoor play area is fenced, and is free from defects and dangerous conditions. There were ample age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. Fire extinguisher, carbon monoxide and smoke detector meet State Fire Marshall standards. The fireplace is screened. Per licensee, there are no firearms in the home. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 9/20/19. All required licensing documents are posted and visible for public review.

At 9:45am, children's files were reviewed. The facility roster was reviewed, and a copy obtained. The licensee is in ratio today. The licensee's Pediatric CPR/First Aid certificate is current and expires 5/8/21, and helper Aruna's is also current. Licensee and helpers have proof of the required immunizations, and current mandated reporter training. Safe Sleep practices were discussed, and new car seat laws were provided. Licensee was reminded that children are never to be left in a parked vehicle.
***Continued on LIC809C...
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: BANERJEE, ANITA
FACILITY NUMBER: 073407243
VISIT DATE: 10/04/2019
NARRATIVE
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The following deficiencies were observed during today's inspection:
  • Upon arrival at 8:55am, LPA observed the child safety gate was not in place at bottom of stairs.
  • At 10:00am, LPA observed, 2 of 6 children's files reviewed do not contain the Identification and Emergency Form (LIC700).

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes 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.

Licensee 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.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

See 809D for deficiencies cited today. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

This report shall remain on file for 3 years. A Notice of Site visit was posted at time of inspection and must remain posted for 30 days.

Exit interview conducted with Anita Banerjee. Copy of report and appeal rights provided.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: BANERJEE, ANITA
FACILITY NUMBER: 073407243
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/04/2019
Section Cited

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Operation of a Family Child Care Home -
Where children less than five years old are in care, stairs shall be fenced or barricaded.
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This requirement was not met as evidenced by:
Based on observation, the child safety gate was not in place at the bottom of stairs, which poses a potential health and safety risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type B
10/11/2019
Section Cited

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Child's Records -
The licensee shall maintain, in each child's record, a copy of the emergency information card required in Section 102417(g)(7).
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This requirement was not met as evidenced by:
Based on records review, 2 of 6 children's files reviewed (C3 and C5) do not contain the ID and Emergency form (LIC700), which poses a potential health and safety risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2019
LIC809 (FAS) - (06/04)
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