515407689-3-2-2020-13-CC-MMAZ-BMBMCF-20200302082929

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 515407689
Report Date: 03/02/2020
Date Signed: 03/02/2020 08:29:37 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	KAUR, RAJWINDER FAMILY CHILD CARE HOME		FACILITY NUMBER:	515407689
ADMINISTRATOR:	KAUR, RAJWINDER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 441-6197
CITY:	YUBA CITY	STATE: CA	ZIP CODE:	95993
CAPACITY:	14	CENSUS: 0	DATE:	03/02/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Rajwinder Kaur		TIME COMPLETED:	08:35 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	A pre licensing inspection was conducted today by LPA Martinez. The applicant is requesting a license for a capacity of 14. Services will be provided Mon-Sun 7:30am-5:30pm. The residence is a three bedroom two bath home. There are two adults and one minor living in the home. The applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. All minors residing in the home must be fingerprinted within 30 days of reaching their 18th birthday and obtain a TB clearance. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance. Children will have access to the front entrance, living room play area, the formal living room and dinning area and one restroom and one bedroom for napping. The laundry room and garage are currently off limits. The sharp knives, cleaning supplies, medicines, are stored out of the reach of children. There are no firearms stored in the home and none were observed during today's visit. The fireplace has a screen protector and the licensee stated the fireplace will not be used. The children in care will have access to age appropriate toys and equipment. The home is equipped with a working smoke detector and carbon monoxide detector. A fire extinguisher rated at least 2A10BC was observed. The children will use backyard as the outdoor play area. The backyard is fully fenced. Emergency drills must be conducted at least once every six months and the date documented. Children's records will be maintained. The roster is to remain current at all times. Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report within seven days. The applicant will maintain current on Pediatric CPR and First Aid. The applicant will remain current on Mandated Reporter Training. The applicant shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current Pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged. Smoking is prohibited at all times in those areas where childcare is provided.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah Martinez	TELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020

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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KAUR, RAJWINDER FAMILY CHILD CARE HOME	FACILITY NUMBER: 515407689
	VISIT DATE: 03/02/2020

NARRATIVE

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The applicant understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website. http://ccld.ca.gov/. Megan's Law web site was provided (http://www.meganslaw.ca.gov). The licensee understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice. This report was reviewed and discussed with the applicant. Guide to Safe Sleeping Practices pamphlet was provided and discussed.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

The following needs to be submitted to the department prior to the issuance of the license:
1. Mandated Reporter Training for Licensee
2. Gate preventing access past outside shed to the side yard area.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah Martinez	TELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020

LIC809 (FAS) - (06/04)

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