434408478-9-11-2019-07-CC-SRED-BFWVWM-20190911164809

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408478
Report Date: 09/11/2019
Date Signed: 09/11/2019 04:48:18 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	SIDHU, KANWALJIT		FACILITY NUMBER:	434408478
ADMINISTRATOR:	SIDHU, KANWALJIT		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 564-5012
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95051
CAPACITY:	14	CENSUS: 11	DATE:	09/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Kanwaljit Sidhu		TIME COMPLETED:	04:55 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 Analysts (LPA) Shannel Reed conducted an unannounced annual/ random inspection to the home today. LPA met with Licensee, Kanwaljit Sidhu, and explained the nature of today's visit. LPA observed The Licensee and her Assistant, Luningning (Ms. Lu) Sadang, with 11 day care children (2 infants, 9 preschool aged) present during this visit. The Licensee stated that the adults that reside in the home are the Licensee, her spouse, and adult sons. All adults have the required fingerprint clearances. The Licensee's CPR/First Aid card is current and expires on 03/21/21. LPA toured the indoor and outdoor areas of the home during today's visit. LPA observed the required posted documentation. LPA observed and obtained a current facility roster. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is clean, orderly, and safe for the day care children. LPA did not observe any wall heaters inside the home. Off limit areas inside the home: 2 bedrooms, 1 bathroom, kitchen, living room, and converted garage. Off limit areas outside the home: in-laws quarters, which has a separate address from the Licensee's home (3168 Humbolt Ave), and grass section of the backyard used exclusively by the tenants in the in-laws quarters. The adult renters enter the property exclusively through the back entrance to the property and have no contact with the day care children. There are no stairs in the home. LPA observed a current Fire Drill log. LPA observed a fully charged 3A10BC fire extinguisher. LPA observed and tested operational smoke and carbon monoxide detectors. Licensee stated that there are no firearms in the home. Detergents, cleaning compounds are inaccessible to children. The Licensee’s son has a dog at the home (Hera, 6 ½ months, Argentine Dogo). The Licensee stated that the dog stays out side in a fenced area. LPA reviewed four 11 Children's files. All files have the required documentation. All required postings were observed and complete. REPORT CONTINUED ON THE FOLLOWING PAGE (REPORT DATED 09/11/19):

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SIDHU, KANWALJIT	FACILITY NUMBER: 434408478
	VISIT DATE: 09/11/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (REPORT DATED 09/11/19):
A review of Staff records indicates that all persons that require a caregiver background check have received criminal record and child abuse index clearance or exemption. LPA informed Licensee of the applicable civil penalties for any adult who has not received fingerprint clearances, is not associated to the license and who comes in contact with or provides care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12- month period.

LPA reviewed the Licensee’s documentation. LPA observed that the Licensee, her spouse who helps with the daycare and her Assistant, Luningning, have not completed the required Mandated Reporter training (AB1207). LPA observed the required immunization's against Pertussis, Measles and an Influenza on file for Ms. Lu. The Licensee and her spouse need to provide proof of immunization's. Supervision of children was discussed with the Licensee. The Licensee stated that she does not transport children via vehicle, but she understands that children cannot be left in parked vehicles unattended at any time.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list, childcareadvocatesprogram@dss.ca.gov.
LPA discussed and provided Lead Safety Information (AB2370) with the Licensee.

Title 22 deficiencies were cited during today’s inspection.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SIDHU, KANWALJIT	FACILITY NUMBER: 434408478
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/11/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/25/2019 Section Cited	1 2 3 4 5 6 7	On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: The Licensee, her spouse and her Assistant, Luningning Sadang have not completed the required Mandated Reporter training (AB1207). This is a potential risk to the children in care and a deficiency to the Health and Safety regulations.	8 9 10 11 12 13 14
Type B 10/11/2019 Section Cited	1 2 3 4 5 6 7	Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: LPA observed that the Licensee does not have the required immunizations against Pertussis, Measles and influenza for herself and her spouse. This poses a potential health and safety risk to children in care and is a deficiency to the Health and Safety regulations.	8 9 10 11 12 13 14

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: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

LIC809 (FAS) - (06/04)

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