384002309-7-29-2021-05-CC-CQUO-C5DU9G-20210729152305

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002309
Report Date: 07/29/2021
Date Signed: 07/29/2021 03:23:59 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SINGH, GITA D.		FACILITY NUMBER:	384002309
ADMINISTRATOR:	SINGH, GITA D.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 819-2913
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94127
CAPACITY:	14	CENSUS: 7	DATE:	07/29/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Licensee, Gita Singh		TIME COMPLETED:	02:30 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	Licensing Program Analyst (LPA) Catrina Quimbo met with licensee, Gita Singh, for a scheduled case management inspection. Present in the home is licensee, licensee’s husband, licensee’s helper, 2 minor children and 6 children (3 preK and 3 infants). All adults living and working in the home have criminal background clearance on file. Licensee is currently licensed for a capacity of 14 children in current facility. Licensee requested to move day care area from main level of home to lower level of home. Updated fire clearance received 07/20/2021. LPA and Licensee inspected home for health and safety hazards. Licensee owns home with husband. Licensee lives in 2-level home with husband and 2 minor children. Main level of home consists of 2 bedrooms, 2 bathrooms, 1 living room, 1 dining room, 1 sun room and kitchen. Lower level of home consists of 1 bedroom (converted to Classroom #1), 1 living room (Classroom#2), 1 bathroom, garage, backyard area and 2 side alleys. Day care areas now approved are: lower level—bedroom #3 (aka Classroom #1), living room #2 (aka Classroom #2), bathroom #3, and backyard area. Off limit areas are: entire upper level of home—bedrooms #1 and #2, bathroom #1 and #2, living room #1, dining room, sun room, kitchen and garage. All off limit areas are properly barricaded. Outdoor stairs leading to and from main level to lower level are properly barricaded by a child safety gate. There are no stairs inside that lead to and from main level to lower level of home. Home has functioning smoke and carbon monoxide detectors. Fire extinguisher is fully charged and accessible. There is a variety of age appropriate toys and materials available to children in care. Backyard area is enclosed with an at least 5ft fence and cushioned with artificial turf and wood chips. Continue Report on Page 2......

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 393-8293
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SINGH, GITA D.	FACILITY NUMBER: 384002309
	VISIT DATE: 07/29/2021

NARRATIVE

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There are no bodies of water in the home. Per licensee, there are no additional living spaces or firearms in the home. All unused electrical outlets are properly covered and made inaccessible. Discipline policy, COVID-19 guidelines and updated safe sleep regulations were discussed. Licensee was reminded to document safe sleep logs for napping infants, conduct emergency drills once every six months and to renew Mandated Reporter training once every two years. Licensee was advised to check CCLD website for any updates and/or provider information notices (PINs).

No deficiencies were issued today under Title 22 Division 12 of the Ca. Code of Regulations. This report and rights to comment and appeal were discussed with Licensee. Copy of report will be emailed to Licensee.

This report is public and can be reviewed. Licensee was advised to call Office line for any additional questions, M-F, 8am-5pm, 650-266-8800. Website: www.cdss.ca.gov

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 393-8293
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

LIC809 (FAS) - (06/04)

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