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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376624591
Report Date: 03/03/2020
Date Signed: 03/03/2020 12:29:28 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:JAISWAL, NIDHI FAMILY CHILD CAREFACILITY NUMBER:
376624591
ADMINISTRATOR:NIDHI JAISWALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 366-9101
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY:14CENSUS: 8DATE:
03/03/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Nidhi JaiswalTIME COMPLETED:
10:20 AM
NARRATIVE
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On 3/3/2020 at 9:20 AM Licensing Program Analysts (LPAs) Keturah Lane and Tresha Souza conducted an unannounced annual/random inspection with the Licensee. Upon arrival LPAs met with Licensee Nidhi Jaiswal. The two-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present were the Licensee, helper Kalyani Wakade and 8 day-care children. Licensee's husband came to the home around 9:45 AM, The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water on the property. Licensee states that there are no weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR certifications expire on 5/30/2020. Licensee has required immunizations. Licensee has not taken the mandated reporter training. Children’s records were reviewed and found to be in order. Last fire/disaster drill was conducted and documented on 12/20/19. Licensee did not have immunizations on file for helper.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include entire first floor including living room, kitchen, family room and patio. Off limits areas includes garage and entire second story and are inaccessible through use of gate at the bottom of the stairs and door knob cover. The licensee has toys and equipment available. The home has a fenced backyard available for outdoor activities. In the backyard, LPA observed some plants with thorns. LPA advised that licensee put up a barrier so the plants are inaccessible to children.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020
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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: JAISWAL, NIDHI FAMILY CHILD CARE
FACILITY NUMBER: 376624591
VISIT DATE: 03/03/2020
NARRATIVE
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Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. Licensee was also provided with information regarding upcoming Safe Sleep Regulations/SIDS and Shaken Baby Syndrome. The ABC’S of Safe Sleep: Sleep is Safest: Alone, on their Back in an empty Crib on a firm mattress. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

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.

Pursuant to Title 22 of the CA Code of Regulations, the following Type B deficiencies were cited (refer to LIC 809-D).

The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. The LIC 9213 (Notice of Site visit) was posted during today's visit.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020
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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: JAISWAL, NIDHI FAMILY CHILD CARE
FACILITY NUMBER: 376624591
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2020
Section Cited

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1597.622(a)(1)Employees...immunization requirements; records(a)(1)...a person shall not be employed...at a family day care home if he or she has not been immunized against influenza, pertussis, and measles...This requirement was not met as evidenced by...
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Based upon staff record review, helper Kalyani Wakade did not have proof of immunizations on file at the home which poses a potential health and safety risk to persons in care.
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Type B
03/31/2020
Section Cited

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1596.8662(b)(1)...training for mandated reporter who is licensed day care provider...(b)(1)On or before March 30, 2018, a person who...is a licensed child care provider...or employee of a licensed child care facility shall complete the mandated reporter training...This requirement is not met as evidenced by...
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Based upon record review and licensee statement, licensee and staff member did not complete the mandated reporter training, which poses a potential health and safety risk to persons in care.
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LPA informed licensee in order to complete the training to visit the following website:
mandatedreporterca.com
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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2020
LIC809 (FAS) - (06/04)
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