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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420796
Report Date: 09/25/2024
Date Signed: 09/25/2024 10:40:39 AM

Document Has Been Signed on 09/25/2024 10:40 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:SULTANI, SHARARAFACILITY NUMBER:
013420796
ADMINISTRATOR/
DIRECTOR:		SULTANI, SHARARAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 386-5727
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
09/25/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Licensee, Sharara SultaniTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee Sharara Sultani for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Present during this inspection was the Licensee supervising four (4) children ( two infants and two preschoolers). The single-story home has three bedrooms: a master bedroom with master bathroom, bathroom #2, living room, family room, kitchen, dining area, laundry room, garage, and backyard.
ON-LIMIT AREAS are bedroom #1, bedroom #2, hallway bathroom, kitchen, dining area, living room and family room (main daycare), and backyard.
OFF-LIMIT AREAS are the master bedroom and bathroom, laundry room, and garage, which are made inaccessible to children by locked doors, and visual supervision at all times.
The home has a working telephone, a working smoke, and a fire extinguisher that meets the minimum requirements. During today's inspection, LPA didn't observe any fireplace or bodies of water. There are child-size tables and chairs for snacks and activities. The Licensee was instructed that smoking, baby bouncers, exersaucers, baby walkers, and similar items are prohibited in the facility during daycare hours. The napping room had cribs in good condition and each child have their separate blankets. The blankets are washed by the provider weekly. The Licensee states there are no guns or weapons of any kind in the home. The Licensee's CPR and first aid is expired since 02/26/2024. Licensee's mandated reporter certificate expires on 12/07/2025. The Licensee provides daily snacks and meals. The discipline policy is redirection. The LPA reviewed the children's files. All the files are complete. All required postings are properly posted. The Licensee conducts and documents fire and disaster drills, the log indicates that the last drill was conducted on 07/02/2024 at 11:00am. The licensee documents 15 minutes sleep check.
See next page...
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SULTANI, SHARARA
FACILITY NUMBER: 013420796
VISIT DATE: 09/25/2024
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During Inspection, 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.

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 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.

Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Type B deficiency is cited today( Please see attached LIC809-D)

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

Exit interview conducted and report was reviewed with the licensee, Sharara Sultani.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/25/2024 10:40 AM - It Cannot Be Edited


Created By: Jyoti Saini On 09/25/2024 at 10:20 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SULTANI, SHARARA
FACILITY NUMBER: 013420796

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. Licensee's CPR and first aid is expired since 02/26/2024 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/04/2024
Plan of Correction
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The licensee shall complete CPR/first-Aid training and submit proof of completion to the department by POC due date. Going forward, this certificate must be renewed every two years.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Wynn Norona
LICENSING EVALUATOR NAME:Jyoti Saini
LICENSING EVALUATOR SIGNATURE:
DATE: 09/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2024


LIC809 (FAS) - (06/04)
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