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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410667
Report Date: 09/25/2019
Date Signed: 09/25/2019 01:25:39 PM

COMPREHENSIVE INSPECTION
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:HAMEED, NAILAFACILITY NUMBER:
434410667
ADMINISTRATOR:HAMEED, NAILA & ABDULFACILITY TYPE:
810
ADDRESS:TELEPHONE:
4085042270
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY:14CENSUS: 1DATE:
09/25/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Naila HameedTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Pete Hernandez and (LPA) Monica Mathur conducted an unannounced annual inspection at the home today. LPA met with Naila Hameed, Licensee, and explained the nature of today's visit to her. Also present today was licensee and visiting mother. There was 1 day care child present at the time of LPA’s arrival. Hours are Monday - Friday from 6:00 AM to 6:00 PM. The Licensee and her spouse,Abdul Hameed, and 17 year old son live in the home.

Licensee stated that Helper Daljit Kaur Saini has been working in the day care since 2008 and transports school age children from their elementary schools to the day care every day. Licensee dis-associated her in March of 2019 but Daljit Kaur Saini continues to work that the day care till date. She is not associated to the facility. A Type A citation was issued and civil penalty of $500 is assessed.

LPA toured the indoor or and outdoor areas of the home. 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 orderly, and safe for the day care children. Off limit areas in the home are the entire upstairs, living room, laundry room, and garage.

LPA observed 1 fully charged 3A40BC fire extinguisher. There are working smoke & carbon monoxide detectors in the home. LPA observed a fenced backyard but a portion of the fence was noted as broken and needs to be repaired. The Licensee states that she does not have any weapons in the home. Detergents, cleaning compounds, were accessible to the children in the bathroom, dining room, and laundry room. The Licensee moved these things out of reach before we left.

LPA reviewed the files of 4 enrolled children and noted incomplete and missing documents for Child 1, 2, and 3. LPA noted incomplete Fire Drill Log and Children Roster.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 09/25/2019:
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
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 6
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: HAMEED, NAILA
FACILITY NUMBER: 434410667
VISIT DATE: 09/25/2019
NARRATIVE
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Website for resource information: http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

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

Due to the issuance of Type A citations today, a copy of the Facility Evaluation Report LIC809 dated 09/25/19 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

LPA conducted an exit interview with the Licensee where this report, citations, civil penalty and appeal rights were discussed.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: HAMEED, NAILA
FACILITY NUMBER: 434410667
VISIT DATE: 09/25/2019
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide 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

Supervision of children was discussed with the Licensee. Licensee understands that she must be present in the home at least 80 percent of the hours the day care is in operation and ensure that the children are supervised at all times. The Licensee understands her capacity options. Licensee understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick child, requirements for reporting suspected child abuse, unusual incidents/injuries, heat-related illnesses, and requirements for assistant/substitute were also discussed.
Licensee did not have a copy of mandated reporter training certificate at the day care during inspection. LPA advised Licensee of the Mandated Reporter Training per AB1207 for Child Care Providers to be accessed at mandatedreporterca.com

LPA informed Licensee that Licensing forms and Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov

LPA discussed with and provided Lead Safety Information (AB2370) to the Licensee.

LPA discussed and provided Safe Sleep Child Care information to the Licensee.

LPA discussed and provided Healthy Beverages in Child Care information (AB2084) to Licensee.
REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3 - REPORT DATED 09/25/2019:
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: HAMEED, NAILA
FACILITY NUMBER: 434410667
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/02/2019
Section Cited

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Child Records: The Licensee shall maintain , in each childs record for all of the required documents, including a copy of the emergency information card, Parents Rights notice. This requirement is not met as evidenced by: Child 1,2,3 have incomplete and missing files.
Type B
11/06/2019
Section Cited

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Operation of a Family Child Care Home. The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: Outdoor play areas shall be either fenced, or outdoor play shall be supervised by the licensee or caregiver.This requirement was not met as evidenced by:
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Per LPA inspection, The left side of the backyard wooden fence had missing boards and was not adiquately made safe for the children as there was a big gap in the fence. This poses an potential rist to the health and safety to the children in care..
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Type B
10/16/2019
Section Cited

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Mandated Reporter requirement.
On or before March 30, 2018, a person who on January, 1, 2018, is a licensed childcare provider, administrator, or employee of a licensed child day care facility must complete the mandated reporter training and shall complete renewal [...] every two years.
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 KnightTELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:
DATE: 09/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2019
LIC809 (FAS) - (06/04)
Page: 6 of 6
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: HAMEED, NAILA
FACILITY NUMBER: 434410667
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2019
Section Cited

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Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement was not met as evidenced by:
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Per LPA inspection, medication was on top of the dining room table and in an Cleaners and chemicals were accessible under the unlocked bathroom sink cabinet. Detergents were within reach in the laundry room which was unlocked. Perfumes, hairspray was accessable on the desk in the dining area. This poses an immediate rist to the health and safety to the children in care.
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Type A
09/26/2019
Section Cited

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Criminal Record Clearance
All individuals subject to a criminal record review[...] shall prior to working, residing, or volunteering in a licensed facility:Request a transfer of a criminal record clearance [...]. This requirement was not met as evidenced by:
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LPA observed that Helper, Daljit Kaur Saini has been working and caring for day care children but is not associated to this day care. This poses an immediate Health and Safety risk to children in care. $500 civil penalty is assessed.
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Due to the issuance of Type A citations today, a copy of the Facility Evaluation Report LIC809 dated 09/25/19 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.
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 KnightTELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:
DATE: 09/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2019
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: HAMEED, NAILA
FACILITY NUMBER: 434410667
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/25/2019
Section Cited

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Operation of a Family Child Care Home. The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home..This requirement was not met as evidenced by:

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Per LPA inspection, the licensee failed to keep current fire drill log. Last fire drill recorded was dated 3/21/18.
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Type B
09/26/2019
Section Cited

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Operation of a Family Child Care Home.The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.This requirement was not met as evidenced by:

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Per LPA inspection, the licensee did not have a completed and updated roster. This poses a potential risk to the health and safety of children in care.
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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: Sandy KnightTELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:
DATE: 09/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6