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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423441
Report Date: 04/30/2024
Date Signed: 04/30/2024 12:28:38 PM

Document Has Been Signed on 04/30/2024 12:28 PM - 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KALANI, POONAMFACILITY NUMBER:
013423441
ADMINISTRATOR/
DIRECTOR:		KALANI, POONAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 787-4061
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 11DATE:
04/30/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Poonam KalaniTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 4/30/2024 at 10:00AM Licensing Program Analyst (LPA) Jaleesa Jackson met with Licensee Poonam Kalani for an Unannounced Annual/Random Inspection visit. Present during the inspection was the Licensee, her husband, her two assistants, 2 infants, and 9 preschool aged children. Licensee lives in the home with her husband and their minor son. Licensee’s home was toured for a health and safety inspection. The facility operates from 8:30AM – 6:00PM, Monday - Friday.

ON LIMITS AREA: Family Room, Living Room, Sun Room/Day Care Room, Backyard, Bathroom #1
OFF LIMITS AREA: Master Bedroom and Bathroom, Three Bedrooms, Hallway Bathroom, Kitchen, left side of backyard and Garage
ISOLATION AREA: Family Room

The facility is a single-story home owned by the Licensee. The inside of the home was observed to be neat, clean with age-appropriate materials for the children. During today's inspection all toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. Licensee stated that she provides all food for the children. All food that is brought from the children’s home will be properly labeled and stored. All napping equipment is clean, well maintained and properly stored. Licensee stated that she does not transport children. There are no pets and no firearms in the home.

There is a fully charged 3A40BC fire extinguisher in the kitchen. There is a working combination smoke/carbon monoxide detector in the home. The home is equipped with central heating and air for proper ventilation. The backyard is fully fenced, clean, well maintained with age-appropriate materials for the children. There are two sheds on the left side of the home used for storage that are gated off and made inaccessible to the children in care. LPA did not observe any harmful bodies of water in or around the home.

Continued 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2024
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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KALANI, POONAM
FACILITY NUMBER: 013423441
VISIT DATE: 04/30/2024
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Licensee is operating within their licensed capacity and is in ratio. LPA Jackson reviewed 12 children's files and 4 staff files that all were complete. Licensee’s Health and Safety training has been completed and Pediatric CPR and First Aid training is complete and expires 2/25/2025. Licensee’s Mandated Reporter training is complete and expires 1/23/2025. Licensee conducts and documents disaster drills at least every 6 months. The last earthquake drill was 2/15/2024 and the last fire drill was 3/12/2024. All adults living and working in the home have obtained a criminal record clearance. All required forms are posted in the entry way of the home.

There were no deficiencies cited on today's visit.

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 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.

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.

Continued on 809-C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024
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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KALANI, POONAM
FACILITY NUMBER: 013423441
VISIT DATE: 04/30/2024
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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 child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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

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

Exit interview conducted and report was reviewed with the licensee Poonam Kalani.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024
LIC809 (FAS) - (06/04)
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