197415059-6-5-2019-30-CC-MSIN-BCUS6G-20190605133554

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197415059
Report Date: 06/05/2019
Date Signed: 06/05/2019 01:36:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	GODHWANI FAMILY CHILD CARE		FACILITY NUMBER:	197415059
ADMINISTRATOR:	GODHWANI, LEELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 773-9073
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91325
CAPACITY:	14	CENSUS: 5	DATE:	06/05/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:47 AM
MET WITH:	Leela Godhwani		TIME COMPLETED:	12:10 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	This is an unannounced annual comprehensive visit conducted by Margarit Sislyan, Licensing Program Analyst (LPA). LPA Sislyan met with licensee, Leela Godhwanil on 6/5/19, who guided analyst on a tour of the facility at 10:40 AM. This is a one story single family home. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. The First Aid kit was observed and complete. Per LIS the facility annual fees are current. The facility roster was observed, and current. Per licensee, there are no weapons or firearms of any kind in the facility currently. The LPA did not observe any weapons. There is no pool, spa or other bodies of water on the premises. There are age appropriate toys and napping equipment on the premises. The required fire extinguisher (2A 10BC) and smoke detectors are in operable condition. Licensee has current copies of CPR/First Aid, expiration dates are 09/20/2019. Licensee has posted as required the License, disaster plan, Parents Rights Poster, Child Seat Safety Law and Earthquake Preparedness Checklist. The following were discussed: No smoking, no infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements and penalty. Fingerprint clearance, transfer process and penalty. The new regulation 102416.3 Alterations to Existing Buildings or Grounds. The Parent Notification AB633 and the licensee discipline practiced by the licensee. The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the is not adhered Licensee was informed that she is a mandated child abuse reporter with the responsibility of reporting any suspected child abuse to the Child Abuse Hotline at (800) 540-4000. Children’s file review was conducted, and LPA observed the files were not complete.

SUPERVISOR'S NAME: Sharon Greene	TELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Margarit Sislyan	TELEPHONE: ((42) 430-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: GODHWANI FAMILY CHILD CARE	FACILITY NUMBER: 197415059
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/05/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/05/2019 Section Cited CCR 102421(a)	1 2 3 4 5 6 7	Child's Records The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d). LPA reviewed children's records and observed the files were not complete.	1 2 3 4 5 6 7	Licensee shall update children's' files according CCLD requirements. POC date 06/15/19
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Sharon Greene	TELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Margarit Sislyan	TELEPHONE: ((42) 430-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: GODHWANI FAMILY CHILD CARE	FACILITY NUMBER: 197415059
	VISIT DATE: 06/05/2019

NARRATIVE

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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

Senate Bill 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.

New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Assembly Bill 1207 (Lopez), Chapter 414, Statutes of 2015: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training.
This training requirement may be directly met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/

Exit Interview Conducted

For additional information and forms visit our website at: www.ccld.ca.gov

SUPERVISOR'S NAME: Sharon Greene	TELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Margarit Sislyan	TELEPHONE: ((42) 430-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

LIC809 (FAS) - (06/04)

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