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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414771
Report Date: 02/07/2020
Date Signed: 02/07/2020 10:28:27 AM

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:SATHAYE, HIMANGI ATULFACILITY NUMBER:
434414771
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
02/07/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:09 AM
MET WITH:Himangi SathayeTIME COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA), Marilou Monico, met with Licensee, Himangi Sathaye, and conducted an unannounced Annual Random Inspection and in response to licensee's request to increase the capacity from 8 to 14 children. Also present during the inspection were licensee's parents-in-law, and five children including one infant and four preschool age. LPA observed that Licensee was providing care and supervision to the children.

The home’s operating days and hours are Monday through Friday from 8:00 AM to 6:00 PM. The home has a working telephone service. The home was inspected inside and out. The home was clean. LPA did not observe flies, other insects, or rodents during the inspection. LPA observed sufficient materials, toys, and play equipment for the day care children. Bathroom used by children was observed to be clean and in operating condition. Food preparation area was clean. LPA observed that cleaning products, sharp objects, medications, and other similar items were stored inaccessible to children.

Areas inside the home that are Off Limit to day care children are entire second floor and kitchen. Off limit areas outside the home: entire backyard. LPA observed swimming pool on the left side section of licensee's home that belongs to the town homes complex. The swimming pool has fence over five feet high with a locked gates. Licensee stated that the swimming pool gates are locked at all times and all town home owners have their own key to open the gates. Licensee stated that there were no weapons stored on the premises. LPA observed a fully charged 2A10BC fire extinguisher. The carbon monoxide detector and smoke detector were tested and observed to be functioning. LPA observed barricaded stairs. Fireplace was barricaded. Fire/disaster drill was last conducted on January 31, 2020. Licensee stated that she provides transportation to the children. LPA advised licensee that children cannot be left in a parked vehicle. LPA observed that licensee maintains current roster of children in care. LPA obtained a copy of children's roster. LPA advised licensee that she is required submit Property Owner/Landlord Consent (LIC 9149) if she decides to care for more than 12 children up to a maximum of 14.
Continuation on next page:
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
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: SATHAYE, HIMANGI ATUL
FACILITY NUMBER: 434414771
VISIT DATE: 02/07/2020
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Licensee completed Assembly Bill (AB)1207 Mandated Reporter Training. Licensee's AB1207 expires February 20, 2021. Licensee has current Pediatric CPR/1st Aid with an expiration date of June 3, 2020.

A review of staff records today's inspection indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. 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. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

LPA reviewed with Licensee the violations that would result in an immediate assessment of civil penalty in the amount of $500. Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov [Shortcut: www.ccld.ca.gov] to access resources for Providers, Regulations, Adoptions of new laws, pay annual fees etc.
Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA reviewed and provided a copy of the “Lead Poisoning Facts Information Flyer” and Safe Sleep information to Licensee. Provider Notice Information (PIN) summary for back up generator safety was provided to Licensee. Capacity and ratio requirements were discussed with licensee.

Medical Services (IMS) policy was discussed. Licensee states she is not planning to provide IMS at this time .

Fire clearance was approved on February 3, 2020.

As a result of this inspection, there were no deficiencies cited. A license for a large family child care home is granted effective today, February 7, 2020.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
LIC809 (FAS) - (06/04)
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