073409017-12-23-2020-02-CC-CFES-BWKVFB-20201223152341

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409017
Report Date: 12/23/2020
Date Signed: 12/23/2020 03:23:47 PM

COMPREHENSIVE INSPECTION

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:	AHMED, IRFANA		FACILITY NUMBER:	073409017
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 2	DATE:	12/23/2020
TYPE OF VISIT:	Required - 1 Year	ANNOUNCED	TIME BEGAN:	02:03 PM
MET WITH:	Irfana Ahmed		TIME COMPLETED:	03:30 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	On December 23, 2020 at 2:03PM, Licensing Program Analyst (LPA) Catherine Fernandes conducted an announced Annual Inspection in conjunction with an increase in capacity inspection with Licensee Irfana Ahmed. Residing in the home is the licensee, her fingerprint cleared husband and adult daughter. Present for the inspection was licensee's husband, two adult daughters, her underage grand-daughter and one preschool child. Due to COVID-19 the home was virtually toured with the Licensee to conduct a health and safety inspection via Facetime. Operating hours will be 7:00AM to 6:00PM, Monday through Friday. The home is a two story house that consists of five bedrooms and two and a half bathrooms. The OFF LIMIT AREAS are the entire upstairs, the kitchen, the formal dining/living room, the laundry room, the left side of the backyard and the garage, which will be inaccessible by closed and/or locked doors or visual supervision. The ON LIMIT AREAS are the family room which is the main area of the day care, the breakfast nook in-between the family room and the kitchen, the downstairs bathroom and bedroom and the large part of the backyard. The ISOLATION AREA will be in the downstairs bedroom. The outdoor play are will be the fenced in backyard, there is an off limit area on the left side of the home that has a separate fence preventing children from entering. LPA observed the following precautions, there is a fire place in the family room that is covered, cabinets and drawers in the breakfast nook have safety latches and the off limit areas have gates to prevent access. Per Licensee, there are no firearms in the home. The home has a fully charged 2A10BC fire extinguisher on the wall in the breakfast nook and pull down fire alarm on the wall next to the on limit bedroom. A working smoke detector in the family room and a carbon monoxide detector next to the kitchen, the telephone is in working condition, and the First Aid Kit is complete. The Licensee's CPR and First Aid certificate is current and expires on 10/26/21. The updated Lead poison training was completed on 11/10/20. The home last fire drill was conducted on 7/7/20. Licensee has confirmed no children in care require medication. Required posters are posted on the parent board. Report continues on 809C.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine Fernandes	TELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

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: AHMED, IRFANA	FACILITY NUMBER: 073409017
	VISIT DATE: 12/23/2020

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The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required training for child care providers, which has been completed on 1/8/20. Facility files were reviewed including a staff file, two of the two children's files and a current children's roster was obtained for the facility file. LPA observed Covid-19 procedures were in place, posters were posted, staff were wearing mask and licensee is taking temperatures once the children arrive.

On 12/17/20, a fire clearance was granted to the facility by Contra Costa Fire Department. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

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. All forms can be downloaded at www.ccld.ca.gov .

As of 12/23/2020, this home is recommended for an increase of capacity.

There are no deficiencies cited today.
The report will remain on file for three years.
An exit interview was conducted with Licensee. Report mailed and emailed.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine Fernandes	TELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

LIC809 (FAS) - (06/04)

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