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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412269
Report Date: 02/15/2023
Date Signed: 02/15/2023 11:35:54 AM


Document Has Been Signed on 02/15/2023 11:35 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:TEJWANI, SUNITA & PRABHU, VIVEKFACILITY NUMBER:
434412269
ADMINISTRATOR:SUNITA & VIVEKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 242-3572
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:14CENSUS: DATE:
02/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:19 AM
MET WITH:TIME COMPLETED:
12:00 PM
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On Wednesday, February 15, 2023 at 10:19 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required 1 Year Visit. LPA met with one of the Licensee's Assistant Inderjit and explained the nature of site visit. Present on the this visit were 9 preschool children, 3 infants and Licensee's Assistant Parneet. The home operates from Monday to Friday 9am to 5pm.

LPA toured the facility to conduct a Health and Safety Inspection with the Licensee. The home is a two story home. The home is neat and clean with heating and ventilation for safety and comfort.
The ON LIMIT AREAS (accessible to children in care) are the living room (use for napping), dining room, kitchen, family room, toy room storage and hallway bathroom, as well as the backyard. The BACKYARD play area is completely fenced.
The OFF-LIMIT AREAS are the entire second floor, all 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 at the bottom of the stairs to prevent access to the second story. The designated isolation area for a child who becomes ill while in care is the living 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 a working telephone. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 01/30/2023. LPA reviewed the Certificate of Liability Insurance from Acord that covers until 06/19/2023.Licensee 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. SEE 809 C.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2023
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: TEJWANI, SUNITA & PRABHU, VIVEK
FACILITY NUMBER: 434412269
VISIT DATE: 02/15/2023
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Continuatio.

The licensees Sunita and Vivek CPR and First Aid Training were taken on on 07/10/2021, and the Licensee's Assistants Inderjit and Parneet CPR and First Aid training were taken on 02/12/2022 and 10/09/2021, respectively. The licensees Sunita and Vivek and the Licensee's Assistants Inderjit and Parneet completed the Mandated Reporter General Training and Child Care Providers training online at https://mandatedreporterca.com/ on 03/18/2022, 09/01/2022, 12/06/2021 and 11/13/2021. Licensees and Licensee's Assistants have records of Measles and Pertussis immunization, Influenza vaccination and TB clearance. LPA reminded Licensee that only the Influenza vaccination can be decline with a written declination.

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, LIC 9227, Infant Sleep Logs and Immunization. The licensee is in ratio today.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

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



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

DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: TEJWANI, SUNITA & PRABHU, VIVEK
FACILITY NUMBER: 434412269
VISIT DATE: 02/15/2023
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Continuation.

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 Child Care 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

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

LPA discussed to the Licensee of the Child Care and Development Infrastructure Grant Program, American Rescue Survey Plan to the Director and Providers must provide Risks, Effects of Lead Poisoning PUB 515 flyer to parents and families upon enrolling or re-enrolling and IMM 874 flyer.



A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

There are no deficiencies cited on this visit.

Exit interview conducted and report was reviewed with the licensee's Assistant, Inderjit Kaur.

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

DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023
LIC809 (FAS) - (06/04)
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