013423341-7-24-2023-52-CC-LDBX-CU2PAV-20230724110923

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423341
Report Date: 07/24/2023
Date Signed: 07/24/2023 11:09:30 AM

Document Has Been Signed on 07/24/2023 11:09 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:	SAHU, SHIBANI		FACILITY NUMBER:	013423341
ADMINISTRATOR:	SAHU, SHIBANI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 829-5471
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94588
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 2	DATE:	07/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Shibani Sahu		TIME COMPLETED:	11:25 AM

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On July 24, 2023, at approximately 09:05 AM, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux conducted an Unannounced Required 1 Year Inspection . Present during today’s inspection was licensee Shibani Sahu, fingerprint cleared husband B. Sahoo, their two children ages 14 and 16 years old and two (2) child in care. The home was toured for Health and Safety Inspection with licensee. Hours of operation are Monday - Friday 8:30 AM - 5:30 PM.

This two story home was clean and orderly, with heating and ventilation for the safety and comfort of children in care.

ON LIMITS: Main home entry for traveling to living room (main day care area), dining room, family room, kitchen, 1 bedroom (first floor) used for napping, and bathroom main level.

OFF LIMITS: The small room/office on main level, two car garage, entire upstairs and master bedroom and bathroom. Isolation Area: The living room away from children in care, until parents pick up. The off-limits are will be made inaccessible by closed and/or locked doors and visual supervision.

There's a gate at the bottom of the stairs to prevent children five years or younger access to the upper floor. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. There are no pools, hot tubs or any other bodies of water present in the on-limit areas during today's inspection. Required postings were all present for public to view. Facility does not provide care for children under 12 months. Licensee is reminded that when operating as a large day care, licensee must have an assistant otherwise, licensee can only have the capacity of a small day care.

The home has a working smoke detector, working carbon monoxide detector, first aid kit, telephone, and fully charged 3A40BC fire extinguisher which meets standards established by the State Fire Marshal, located in the garage. There's a fireplace in the living room which is screened to prevent access by children. The licensee is in compliance with the immunization laws which pertains to all childcare providers. Per licensee, there are no firearms in the home.

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: SAHU, SHIBANI	FACILITY NUMBER: 013423341
	VISIT DATE: 07/24/2023

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The OUTDOOR PLAY area is the fully fenced front, side, and backyard and LPA observed that it is free from defects or dangerous conditions. There are no play structures which are required to be anchored during today's inspection. There's a shed with a lock to prevent children access to equipment on the side-yard. There are ample age appropriate toys that appear to be safe and in good condition.

At 10:00 AM, LPA requested and reviewed two (2) children files. The licensee's Health and Safety training is complete, and CPR and First Aid certificate is current and expires 09/18/2023. The licensee mandated reporter training is current and expires on 09/06/2023. The licensee is in compliance with the immunization laws which pertains to all childcare providers. All required forms are posted and visible for public review.

Effective August 1, 2003 California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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/.

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-andresources/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.

See 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

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: SAHU, SHIBANI	FACILITY NUMBER: 013423341
	VISIT DATE: 07/24/2023

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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.

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.

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

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

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Appeal Rights Provided. Exit interview conducted and report was reviewed with the licensee, Shibani Sahu.

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

LIC809 (FAS) - (06/04)

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