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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005620
Report Date: 10/13/2021
Date Signed: 10/14/2021 08:05:28 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CHEEMA FAMILY CHILD CAREFACILITY NUMBER:
198005620
ADMINISTRATOR:CHEEMA,KULWANTFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 396-6219
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY:14CENSUS: 3DATE:
10/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Kulwant Cheema, LicenseeTIME COMPLETED:
03:25 PM
NARRATIVE
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Prior to entrance to the facility, LPA Lucero conducted a COVID-19 assessment and based on the licensee responses to the facility assessment questions, LPA Lucero determined it was safe to proceed. On October 13, 2021 at 11:50am, Licensing Program Analyst (LPA) Lucero conducted an unannounced Required One Year Inspection. LPA met with Licensee Kulwant Cheema who guided LPA on an indoor and outdoor tour of the facility. There was one child present at the initial time of inspection and LPA did not observe other adults in the home at time of inspection. Family members residing in the home was discussed with licensee and are cleared.

This facility is a two story home that consists of four bedrooms, three bathrooms, kitchen, living room, dining area, family room, attached garage, front and backyard. Per licensee, areas accessible to children and identified on the facility sketch were inspected by LPA which consists of family room, dining area, one bathroom, kitchen and back yard. Per Licensee, areas off-limits to children and identified on the facility sketch are all of upstairs, living room, licensee's master bedroom with master bathroom, front yard and attached garage.

At approximately 12:05pm, LPA began the facility to inspect for safety, comfort, cleanliness, ventilation and working phone. For ventilation, LPA observed that the facility has central air and heating. LPA observed a fireplace in the living room with a screen. LPA observed the furniture and children materials to be in good condition and age appropriate. LPA observed a safety gate barrier in place at the staircase. LPA observed the Children Roster, LIC 610A Emergency Disaster Plan, PUB 394 Parent’s Rights, emergency drills posted on the Parent Board at facility entrance.

At approximately 12:15pm, LPA entered the restroom and observed the toilet, hand washing sink, running water, towel, and hand soap. LPA observed the bottom cabinets closed and with a child proof lock in place making it inaccessible to children to open cabinet doors. LPA observed the restroom to be in good condition.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Armando J LuceroTELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CHEEMA FAMILY CHILD CARE
FACILITY NUMBER: 198005620
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/13/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as the CPR card licensee has was issued by the National CPR Foundation and does not have the EMSA certified stickers. This poses a potential risk to children in care.
POC Due Date: 11/15/2021
Plan of Correction
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Licensee stated that she will contact the National CPR Foundation to determine if she can obtain the EMSA certified stickers. Licensee stated that if she cannot obtain the EMSA stickers, she will enroll in a CPR course with American Red Cross and submit a copy of the card to LPA via email by Plan of Correction date of 11/15/2021.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Armando J LuceroTELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:
DATE: 10/13/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/13/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CHEEMA FAMILY CHILD CARE
FACILITY NUMBER: 198005620
VISIT DATE: 10/13/2021
NARRATIVE
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At approximately 12:20pm, LPA observed cleaning compounds items stored inside the bottom bathroom sink. LPA observed child proof locks in place making it inaccessible to children to open the cabinets and drawers. For drinking water, LPA observed water container and water bottles.

LPA asked if there are any pets, poisons, firearms, weapons or bodies of water. Licensee stated she has no pets, and no body of waters, firearms, weapons or poisons. LPA did not observe bodies of water on the premises. Licensee was advised that if any poisons (ex: Drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



At approximately 12:45pm, LPA observed the required 2A10BC fire extinguisher located in the laundry room and the valve on the green area indicating fully charged. LPA observed the smoke detector and carbon monoxide detector in the hallway. Licensee tested detectors until a beeping sound emanated from the dual device. The smoke and carbon detectors appear to be in good condition. At approximately 12:30pm, LPA inspected the outdoor area used by children for safety, comfort and cleanliness. LPA observed play equipment to be in good condition and age appropriate.

Licensee stated that at 1:00pm she had to leave the day care and pick up two children from school. LPA left the home at 1:00pm, worked on the report until Licensee returned at 1:45pm. Upon Licensee's arrival at 1:45pm, LPA observed two more children in care with Licensee and LPA resumed inspection of facility.

At approximately 2:00pm, LPA conducted a records review. LPA observed licensee’s Pediatric First Aid/ CPR card issued by the National CPR Foundation with completed date of 05/14/2020. LPA did not observe the EMSA certified stickers on the card. Discussion was held with Licensee regarding the importance of maintaining current Pediatric CPR/First Aid certification. LPA determined that Licensee has not completed the Mandated Reporter Training (AB 1207). Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com and is also available in Spanish. Technical issued. LPA observed the files to be up to date.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at:

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Armando J LuceroTELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CHEEMA FAMILY CHILD CARE
FACILITY NUMBER: 198005620
VISIT DATE: 10/13/2021
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https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Kulwant Cheema of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at also explained to licensee that car seat, stroller are only and only for https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 Kulwant Cheema 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.

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. See deficiencies page for deficiencies cited. Exit interview conducted and report was reviewed with the licensee Kulwant Cheema.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Armando J LuceroTELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4