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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416440
Report Date: 06/21/2021
Date Signed: 06/21/2021 03:47:39 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:COHEN-SAVRANSKY, ALIZAFACILITY NUMBER:
434416440
ADMINISTRATOR:COHEN-SAVRANSKY, ALIZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 485-9961
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:14CENSUS: 6DATE:
06/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Aliza Cohen-SavranskyTIME COMPLETED:
04:00 PM
NARRATIVE
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#1 Licensing Program Analysts (LPAs), Marilou Monico and James Santos conducted an unannounced Required 1 Year Inspection today. LPAs met with Licensee, Aliza Cohen-Savransky, and explained the purpose of the inspection. Also present in the home were licensee's 16 year old assistant, licensee's two children ages 14 and 10 years old, and six daycare children including five preschool age and 1 school age. There are two (2) adults residing in the home: Licensee and her husband.

LPAs toured the home inside and out with the Licensee. The home’s operating schedule is Monday through Friday from 7:00 AM to 7:00 PM. The home has a working telephone service. The License, Notification of Parents’ Rights, Emergency Disaster Plan, and Earthquake Preparedness Checklist were observed to be posted. The home was observed to be clean and organized. There were sufficient toys and play equipment for the day care children. LPAs observed sharp knives located under the kitchen counter accessible to children. Bathroom used by children was observed to be clean and in good operating condition.

Off limit areas in the home: entire upstairs, two bedrooms and garage on the first floor. LPAs observed that the stairs were not barricaded. There were no bodies of water observed. Per licensee, there were no weapons and poisons in the home. A fully charged 3A40BC fire extinguisher was observed. LPAs observed functioning carbon monoxide and smoke detector. Licensee states that she has not practiced fire or disaster drill with the children.

Children's roster was not up-to-date. Four (4) children's files were reviewed. LPAs discussed with Licensee Assembly Bill (AB) 1207 (Mandated Child Abuse Reporting Training) which is required training that began on January 1, 2018 and requires renewal every two years. Mandated Reported Training can be accessed at www.mandatedreporterca.com. Licensee completed AB1207 Mandated Reporter Training that expires on 03/15/2022 . Licensee has current Pediatric CPR/1st Aid certification with an expiration date of 06/23/2022.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2021
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 4
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: COHEN-SAVRANSKY, ALIZA
FACILITY NUMBER: 434416440
VISIT DATE: 06/21/2021
NARRATIVE
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A review of staff records during 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. LPAs 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.

LPAs reviewed with Licensee the violations that would result in an immediate assessment of civil penalty in the amount of $500. Licensees are 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.

LPAs reviewed and provided licensee the Safe Sleep Regulations (PIN 20-24-CCP).

Incidental Medical Services (IMS) policy was discussed. Licensee stated that she's not planning to provide IMS at this time.

As a result of this inspection, deficiencies were cited. See LIC809D pages for deficiencies.



A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED TOGETHER WITH TYPE A DEFICIENCY VISIBLE TO PARENTS FOR A PERIOD OF 30 DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: COHEN-SAVRANSKY, ALIZA
FACILITY NUMBER: 434416440
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/21/2021
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 is not met as evidenced by:
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LPAs observed knives stored in the drawer located below the kitchen counter accessible to children. This poses an immediate risk to the health and safety of children in care.
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Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

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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: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: COHEN-SAVRANSKY, ALIZA
FACILITY NUMBER: 434416440
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2021
Section Cited

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Operation of a Family Child Care Home - Where children are less than five years old in care, stairs shall be fenced or barricaded. This requirement is not met as evidenced by: LPAs observed that the stairs were not barricaded and there were daycare children less than five years old present in the home. This poses a potential risk to the health and safety of children in care.
Type B
06/28/2021
Section Cited

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Operation of a Family Child Care Home - All homes shall have a current roster of the children. This requirement is not met as evidenced by: LPAs observed that licensee does not have current Children's Roster. This poses a potential risk to the health and safety to children in care.
Type B
06/28/2021
Section Cited

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Operation of a Family Child Care Home - All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. This requirement is not met as evidenced by: Licensee states that she has not practiced fire or disaster drills with the children. 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: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4