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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410678
Report Date: 08/03/2021
Date Signed: 08/03/2021 01:10:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:SHARMA, SAVITAFACILITY NUMBER:
434410678
ADMINISTRATOR:SHARMA, SAVITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 956-9725
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:14CENSUS: 8DATE:
08/03/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Savita SharmaTIME COMPLETED:
01:15 PM
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On Tuesday, August 3, 2021 at 11:32 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required 1 Year visit. LPA met with the Licensee and explained the nature of site visit. Present on this visit were Licensee's spouse, Licensee's daughter, Licensee's assistant, 4 infants and 4 preschool children. licensee stated that the facility operates from Monday to Friday from 8:30 am to 6pm.

LPA toured the facility to conduct a health and safety inspection. The home is neat and clean with heating and ventilation for safety and comfort. The On Limit Area are the Living Room, Family Room, hallway bathroom, Kitchen and the backyard. LPAs observed that there were children’s toys, play equipment and materials. Furniture and equipment for children's use, such as tables and chairs were in good condition and age appropriate, There were no baby walkers observed to be in use during today’s inspection. The backyard play area is completely fenced. The Off Limit Area are the front yard, all the bedrooms and the garage which will be inaccessible to children in care by closed and or locked doors and or a fence with visual supervision. There is a gate located in between the hallway and all the bedrooms. The designated isolation area for a child who becomes ill while in care is the family room. There are ample age appropriate toys that appear to be safe and in good condition. There are no pools, hot tubs or any other bodies of water present during today's inspection. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible today.

The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector and working telephone. Per licensee, there are no firearms in the home. The licensee stated that the facility conducts fire and disaster drills everyday. LPA advised the licensee fire and disaster drill are only required once every 6 months. Licensee owns the house and has childcare liability insurance.

SEE 809 C..........
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021
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 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SHARMA, SAVITA
FACILITY NUMBER: 434410678
VISIT DATE: 08/03/2021
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Continuation........

The licensee CPR and First Aid certificate and expires on June of 2022. The licensee will complete the Mandated Reporter General Training and Child Care Providers training online at https://mandatedreporterca.com/ Licensee stated that all the adults in the facility had COVID 19 vaccination.

Facility roster of children was reviewed, and a copy was obtained. Children’s files were reviewed, which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, and Immunization. The licensee is in ratio today.

Licensee stated that she does not transport children at this time. Licensee has a current and valid Driver License. Licensee understands that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children in care shall be maintained in safe operating conditions and all vehicle occupants must be secured in an appropriate restraint system.

LPA discussed the California Child Safety Seat Law and provide the web link https://www.chp.ca.gov/Programs-Services/Programs/Child-Safety-Seats for more information.

Individual Medical Services (IMS) policy was discussed. 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: https://www.ada.gov/childqanda.htm.



The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility.

SEE 809 C.......

SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SHARMA, SAVITA
FACILITY NUMBER: 434410678
VISIT DATE: 08/03/2021
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Continuation......

Licensee is reminded that all assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. To file a complaint regarding a state licensed community care facility or child care facility, call Community Care Licensing Division Complaint Hotline 1-844-538-8766 or email letusno@dss.ca.gov

LPA Estoesta discussed, provided copies of Guardian website, New Safe Sleep Brochure and Lead Poisoning Facts Flyerto the licensee. For more information, please follow the links https://cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, https://cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

Licensee is encouraged to visit the Department’s website to access resources for Providers, Title 22 Regulations, online option to pay Annual License fee, all forms can be downloaded, Child Care Resource & Referral Network (R&Rs) and more information at https://cdss.ca.gov/inforesources/child-care-licensing. This website link https://ccld.childcarevideos.org/ includes videos that explain licensing topics relevant to families and licensed child care providers.



Effective August 1, 2003 California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

For licensing updates, advised Licensee to email childcareadvocatesprogram@dss.ca.gov and request to be added to the email list. There are no deficiencies cited on this visit. This report shall remain on file for 3 years. A copy of the appeal rights was provided. A notice of site visit was given and must remain posted for 30 days.



Exit interview conducted.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3