376627611-8-3-2022-51-CC-ASUD-CGXPAC-20220803110831

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376627611
Report Date: 08/03/2022
Date Signed: 08/03/2022 11:08:46 AM

Document Has Been Signed on 08/03/2022 11:08 AM - It Cannot Be Edited

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:	KANDASAMY PALANISAMY, DEEPA FAMILY CHILD CARE		FACILITY NUMBER:	376627611
ADMINISTRATOR:	DEEPA KANDASAMY PALANISANY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(425) 647-3967
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92129
CAPACITY:	14	CENSUS:	DATE:	08/03/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Sugirtha Subramanian		TIME COMPLETED:	11:15 AM

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 8/3/22 at 9:15 AM Licensing Program Analyst (LPA) Annette Sutherland conducted an unannounced annual inspection with the Licensee’s helper Sugirtha Subramanian. Also present was Helper Meenakshi Aravine who were provided the Inspection Checklist (LIC 126). The 2-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present in the home were 10-day care children. The facility is within ratio and capacity. Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for childcare include Living room, Bedroom #1, Bathroom #1 and Backyard. Off limits areas include Entire upstairs, Dining room, Kitchen, Family room, Laundry room, and Garage and are inaccessible through use of doorknob covers and safety gates. Stairs are properly barricaded. Fireplace is in an off-limit area. The licensee has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. Last fire drill was conducted on 2/15/2022. LPA conducted childcare quality management interview with the Licensee's helpers . 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. Sugirtha states that there are no weapons in the home. First Aid and CPR certifications expire on 2/19/24 for Sugirtha Subramanian and 3/26/24 for Meenakshi Aravind . Helpers both have required immunizations. Sugirtha Subramanian completed Mandated Reporter Training on 3/27/22 and Meenakshi Aravind completed it on 3/26/22 and are reminded it must be completed every 2 years. Children’s and Staff records were reviewed and found to be in order. Continued on LIC 809

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette Sutherland	TELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

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: KANDASAMY PALANISAMY, DEEPA FAMILY CHILD CARE	FACILITY NUMBER: 376627611
	VISIT DATE: 08/03/2022

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; 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. LPA reviewed Covid-19 guidelines with Licensee and provided Covid-19 resources. LPA directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
LPA discussed the safe sleep regulations with licensee and discussed the Childcare Licensing Safe Sleep web page 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.
LPA reviewed with Licensee the LIC 311D, Forms/Records. To Keep in Your Family Childcare Homes, children’s forms/records, facility forms/records, and information to be posted. 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.
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 Childcare 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 and provided Licensee with the following: childcare advocates-email address: childcareadvocatesprogram@dss.ca.gov .

Continued on LIC 809C

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette Sutherland	TELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

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: KANDASAMY PALANISAMY, DEEPA FAMILY CHILD CARE	FACILITY NUMBER: 376627611
	VISIT DATE: 08/03/2022

NARRATIVE

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In addition, for general questions or questions regarding licensing requirements contact the Childcare Licensing Duty Line at (619) 767-2248.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Childcare 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 Childcare Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

No deficiencies cited.

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/inspection-process.

Exit interview conducted and report was reviewed with the licensee’s helper Sugirtha Subramanian. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette Sutherland	TELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

LIC809 (FAS) - (06/04)

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