013422894-8-16-2023-52-CC-LDBX-CURPTL-20230816113608

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422894
Report Date: 07/24/2023
Date Signed: 08/16/2023 11:36:15 AM

Document Has Been Signed on 08/16/2023 11:36 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:	RAIKAR, KIRAN		FACILITY NUMBER:	013422894
ADMINISTRATOR:	RAIKAR, KIRAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 203-0214
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94588
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 6	DATE:	07/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Kiran Raikar		TIME COMPLETED:	11:45 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	On August 16, 2023, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux met with licensee Kiran Raikar for the purpose of conducting an unannounced Annual Required inspection for Health and Safety compliance. Present for the inspection was one (1) fingerprint and TB cleared staff and six (6) children in care. Licensee provides care for children starting at the age of 2.5 years of age. Hours of operation Monday - Friday 8:15 am to 5:30pm. The facility is a two story home consisting of a kitchen, living room, family room, one master bedroom with bathroom, two additional bedrooms, an attached 2-car garage and an enclosed and fully fenced private backyard. ON LIMITS areas: includes the kitchen, living room, one bedroom across from the bathroom, main house bathroom in the hall, and the back yard. OFF LIMITS areas: one bedroom/loft upstairs, master bedroom and bathroom, the attached two car garage, and entire second floor of home. Isolation Area: in the living room away from the children in care until parents arrive. Off-limit areas will be inaccessible by closed and/or locked doors, child gates and/or by supervision. The home is neat and clean, with heating and ventilation for safety and comfort. LPA did not observe any hazardous materials or toxins accessible to children today. The facility had a working smoke detector and carbon monoxide detector (both tested and functioning), working telephone, fully stocked first aide kit and fully charged 3A40BC fire extinguisher (kitchen). Per licensee, there are no firearms in the home. No bodies of water such as pools or hot tubs were accessible to children. There are no hazard material accessible to children during today's visit all poisons, detergents, and medication were also inaccessible to children in care. The fireplace is screened off in the living room. 809-C

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: RAIKAR, KIRAN	FACILITY NUMBER: 013422894
	VISIT DATE: 07/24/2023

NARRATIVE

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LPA requested and reviewed children and staff files at 10:30 AM. Five (5) children files were reviewed. . All files contained Immunization, Parent's Rights, and Medical Consent forms. The facility roster was reviewed, and copies were obtain. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 02/03/2023. The licensee's Health and Safety training is completed, and CPR and First Aid certificate, assistant CPR/First Aide is current and expires 7/25. The licensee has completed mandated reporter training and the certificate expires 01/09/24. All required forms are posted and visible for public review. Per licensee does not administer medication.

Licensee was reminded that California law requires Licensee’s to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department of social services within 24 hours by phone, fax, or email. Within seven (7) days from the incident, Licensee’s must submit the Unusual Incident/Injury form (LIC 624B) to the Department. Licensee was reminded that any structural changes or additions to the home must be reported to Community Care Licensing. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting https://mandatedreporterca.com/. LPA informed licensee that all forms can be downloaded at www.ccld.ca.gov.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: RAIKAR, KIRAN	FACILITY NUMBER: 013422894
	VISIT DATE: 07/24/2023

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

During the exit interview, the LICENSEE Kiran Raikar , confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Assistant 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. (per licensee does not provide care for children under 24 months)

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

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

Exit interview conducted and report was reviewed with the Licensee Kiran Raikar..

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC809 (FAS) - (06/04)

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