073408625-11-15-2023-52-CC-JPLA-CXLS7Z-20231115123823

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408625
Report Date: 11/15/2023
Date Signed: 11/15/2023 12:38:36 PM

Document Has Been Signed on 11/15/2023 12:38 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SILVA, CHAMANI		FACILITY NUMBER:	073408625
ADMINISTRATOR:	SILVA, CHAMANI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 804-6700
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94583
CAPACITY:	14	CENSUS: 3	DATE:	11/15/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Chamani Silva		TIME COMPLETED:	12:50 PM

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On November 15, 2023 at 9:20am, Licensing Program Analyst (LPA) Julia Placencia arrived at the facility unannounced to conduct a Required-3 Year Inspection. LPA met with licensee Chamani Silva. Also residing in the home is the licensee’s mother Dona Pannipitiyaachc and husband Prabhath Silva. The facility is a two story house. Hours of operation for child care are Monday through Friday, 9:00am to 5:30pm. Currently children enrolled only attend for half a day. The following was observed during today’s inspection:

Capacity/Staffing: The facility operates as a Family Child Care Home (large), which may have a maximum capacity of twelve (12) to fourteen (14) children. At time of inspection, there were three (3) children (two preschoolers, and one school age child arrived after school). The facility is in compliance with ratio and capacity limitations.

ON Limit areas (accessible to children in care): Entire first floor, backyard. LPA observed the facility to be clean and in good repair, with heating and ventilation for safety and comfort. There was a child safety gate at the bottom of stairs. There are ample age appropriate toys that are observed to be safe and in good condition. The backyard has a fence surrounding the perimeter of the yard. Licensee has a dog and provided proof of vaccinations. LPA did not observe any toxic items accessible to children in the ON Limit areas of the facility today.

OFF Limit areas (not accessible to children in care): Entire second floor, Fish Pond area in back left corner of yard which is barricaded by a five foot high fence, Garage. OFF Limit areas are inaccessible by closed and/or locked doors and visual supervision. Licensee is advised to contact Licensing so that an inspection can be completed prior to changing an OFF Limit area to ON Limit.

Emergency Preparedness/Safety: Facility has a fully charged 3A40BC fire extinguisher. Smoke and carbon monoxide detectors were tested and found to be functioning. First aid supplies are available. A fire/disaster drill was last conducted on 10/3/2023 and meets the six month requirement. Facility has phone service. Per licensee, there are no firearms in the home. Emergency Disaster Plan is current (11/27/17). ***Continued on LIC 809C...

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SILVA, CHAMANI	FACILITY NUMBER: 073408625
	VISIT DATE: 11/15/2023

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Staff Records Review: Licensee and all adults living and/or working in the home have proper criminal background clearances. Licensee has current CPR/First Aid training, which expires on 12/18/2023, and mandated reporter training expires 12/14/2023. Licensee's mother, who occasionally helps, is exempt from mandated reporter training as English is not her first language. Licensee and mom are in compliance with immunization law.

Children’s Records Review: All required licensing documents were observed. Facility does not have Liability Insurance and Affidavits are in each child’s file. A facility roster is maintained.

Licensing Posting: Facility license, Notification of Parents’ Rights, Earthquake Preparedness.

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 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee, and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Per licensee, she only accepts children over 2 years old.

***Continued on LIC 809C...

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SILVA, CHAMANI	FACILITY NUMBER: 073408625
	VISIT DATE: 11/15/2023

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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.

There are no deficiencies cited during today's inspection.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Chamani Silva.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

LIC809 (FAS) - (06/04)

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