<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700036
Report Date: 04/19/2023
Date Signed: 04/19/2023 03:45:12 PM

Document Has Been Signed on 04/19/2023 03:45 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KAUR, KAMALPREETFACILITY NUMBER:
015700036
ADMINISTRATOR:KAUR, KAMALPREETFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 676-5744
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
04/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Kamalpreet KaurTIME COMPLETED:
03:55 PM
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 April 19, 2023 at 11:30am, Licensing Program Analyst (LPA) Julia Placencia arrived at the facility unannounced to conduct a Required-1 Year Inspection. LPA first met with helper Komalpreet Kaur as the licensee was not home. Licensee Kamalpreet Kaur arrived about 30 minutes later. Also residing in the home is the licensee's 15 year old daughter. The facility is a one story house. Hours of operation for child care are Monday through Friday, 8:30am to 6:00pm. The following was observed during today’s inspection:

Capacity/Staffing: The facility operates as a Family Child Care Home (large), which may have a maximum capacity of twelve (12) to fourteen (14) children. At time of inspection, there were thirteen (13) children (four infants and nine preschoolers) and helper Komalpreet Kaur.

ON Limit areas (accessible to children in care): Kitchen, Living Room, Two Bedrooms to the Right in Hallway, Bathroom at End of Hallway, Sunroom, and Backyard. LPA observed the facility to be clean and in good repair, with heating and ventilation for safety and comfort. There were ample age appropriate toys that were observed to be safe and in good condition. The backyard has a fence surrounding the perimeter of the yard. There are no pools, hot tubs or other bodies of water. LPA did not observe any hazardous or toxic items accessible to children in the ON Limit areas of the facility today.

OFF Limit areas (not accessible to children in care): Master Bedroom/Bathroom, Garage (converted into another room for personal use). ***The Right Side Yard is OFF Limits as of today (licensee will clean up this side and ensure it is safe for children and notify licensing when ready to be placed ON Limit). OFF Limit areas are inaccessible by closed and/or locked doors and visual supervision. Licensee is advised to contact Licensing so that an inspection can be completed prior to changing an OFF Limit area to ON Limit.

Emergency Preparedness/Safety: Facility has a fully charged fire extinguisher. Smoke and carbon monoxide detectors were tested and found to be functioning. First aid supplies are available. A fire/disaster drill was last conducted on 1/10/23 and meets the six month requirement. Facility has phone service. Per licensee, there are no firearms in the home. Emergency Disaster Plan is current (9/20/19). ***Continued on LIC 809C...

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE: DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/19/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 10
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: KAUR, KAMALPREET
FACILITY NUMBER: 015700036
VISIT DATE: 04/19/2023
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
26
27
28
29
30
31
32
Staff Records Review: Licensee and all adults living and/or working in the home have proper criminal background clearances. Licensee is in compliance with immunization requirements for day care providers.

Children’s Records Review: All required licensing documents were reviewed. Facility has Liability Insurance. A facility roster is maintained.

Licensing Posting: Facility license, Notification of Parents’ Rights, Earthquake Preparedness, Emergency Disaster Plan, Fire Drill Log

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.



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.

***Continued on LIC 809C...

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 2 of 10
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: KAUR, KAMALPREET
FACILITY NUMBER: 015700036
VISIT DATE: 04/19/2023
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
26
27
28
29
30
31
32
Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

The following deficiencies were cited during today's inspection:
  • Upon arrival, LPA observed there were 13 children (4 infants and 9 preschoolers), and only the helper Komalpreet was initially present.
  • Upon arrival, LPA observed 6 children playing in the OFF Limits garage.
  • At 12:30pm, LPA observed the tall shelf in the left side yard is not secured to the wall. The shelf is approximately 5 feet tall.
  • During review of records, LPA observed licensee does not have current mandated reporter training on file.
  • During review of records, LPA observed licensee does not have current CPR/First Aid on file.
  • During review of records, LPA observed a 15 minute Infant Sleep Log is not maintained.

See 809D for deficiencies cited today. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Please see LIC 9102 for Advisory Notes.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC 9224). The LIC 9224 must be placed in each child's file to be reviewed by licensing.

***Continued on LIC 809C...
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 3 of 10
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: KAUR, KAMALPREET
FACILITY NUMBER: 015700036
VISIT DATE: 04/19/2023
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
26
27
28
29
30
31
32
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

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

Exit interview conducted and report was reviewed with licensee Kamalpreet Kaur.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 4 of 10
Document Has Been Signed on 04/19/2023 03:45 PM - It Cannot Be Edited


Created By: Julia Placencia On 04/19/2023 at 02:32 PM
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: KAUR, KAMALPREET
FACILITY NUMBER: 015700036

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation the licensee did not comply with the section cited above as there were 13 children (4 infants and 9 preschool age) with only a helper present, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/20/2023
Plan of Correction
1
2
3
4
By POC date, licensee shall comply with the capacity requirements for a small family child care home if the licensee is not present with the helper, and also immediately reduce the number of children to within her ratio/capacity limits. An assistant is required at all times to operate as a large family child care home. Licensee shall submit a statement of understanding of this regulation and submit to LPA via email by 4/20/23. LPA will return on another date to ensure compliance.
***Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:Jason Jang
LICENSING EVALUATOR NAME:Julia Placencia
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023


LIC809 (FAS) - (06/04)
Page: 5 of 10
Document Has Been Signed on 04/19/2023 03:45 PM - It Cannot Be Edited


Created By: Julia Placencia On 04/19/2023 at 02:32 PM
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: KAUR, KAMALPREET
FACILITY NUMBER: 015700036

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above as there is a tall shelf in the left side yard which is not secured to the wall, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/26/2023
Plan of Correction
1
2
3
4
Licensee shall remove shelf or secure to wall and submit proof to LPA by due date of 4/26/23.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above as she does not have current mandated reporter training on file, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/03/2023
Plan of Correction
1
2
3
4
Licensee shall complete the mandated reporter training for "child care providers" and submit copy of certificate to LPA by due date of 5/3/23.
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:Jason Jang
LICENSING EVALUATOR NAME:Julia Placencia
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023


LIC809 (FAS) - (06/04)
Page: 6 of 10
Document Has Been Signed on 04/19/2023 03:45 PM - It Cannot Be Edited


Created By: Julia Placencia On 04/19/2023 at 02:32 PM
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: KAUR, KAMALPREET
FACILITY NUMBER: 015700036

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023

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
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above as she does not have current pediatric CPR/first aid on file, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/26/2023
Plan of Correction
1
2
3
4
Licensee showed LPA proof that she has enrolled in the CPR/first aid class on 4/22/23. Licensee is advised to submit copy of certificate when complete, by due date of 4/26/23.
Type B
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, licensee did not comply with the section cited above as LPA observed 6 children playing in the OFF Limits garage, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/26/2023
Plan of Correction
1
2
3
4
Licensee shall submit a plan as to how she will ensure children do not play in the OFF Limits garage or any other Off Limits room. Submit plan to LPA by due date of 4/26/23.
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:Jason Jang
LICENSING EVALUATOR NAME:Julia Placencia
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023


LIC809 (FAS) - (06/04)
Page: 7 of 10
Document Has Been Signed on 04/19/2023 03:45 PM - It Cannot Be Edited


Created By: Julia Placencia On 04/19/2023 at 02:32 PM
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: KAUR, KAMALPREET
FACILITY NUMBER: 015700036

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above as there is no record of 15 minute infant sleep checks being maintained, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/26/2023
Plan of Correction
1
2
3
4
Licensee shall start maintaining a sleep log for each infant under 24 months and submit to LPA on 4/26/23.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:Jason Jang
LICENSING EVALUATOR NAME:Julia Placencia
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023


LIC809 (FAS) - (06/04)
Page: 8 of 10