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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700036
Report Date: 05/11/2022
Date Signed: 05/11/2022 03:23:29 PM

Document Has Been Signed on 05/11/2022 03:23 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KAUR, KAMALPREET & SARN, RANJODHFACILITY NUMBER:
015700036
ADMINISTRATOR:KAUR, KAMALPREETFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 676-5744
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY: 14TOTAL ENROLLED CHILDREN: 16CENSUS: 14DATE:
05/11/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:37 PM
MET WITH:Kamalpreet KaurTIME COMPLETED:
03:42 PM
NARRATIVE
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On 5/11/2022, Licensing Program Analyst (LPA) Jonathan Williams arrived to the facility unannounced for an unrelated matter. LPA was met by Licensee, Kamalpreet Kaur, and one fingerprint cleared and associated assistant. Present for today's visit were 14 children in care (five infants, seven preschoolers, and two school-aged children).

The facility was out of ratio during today's visit. Licensee was reminded that no more than three infants may be cared for during any time when more than 12 children are being cared for. Type A deficiency is cited. Licensee was reminded that LIC9224 must be signed by all parents of children in care and parents of all children subsequently enrolled for a period of 12 months from today's date.

Appeal Rights provided. Exit interview conducted. Notice of site visit was given and must remain posted for a period of 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE: DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/11/2022
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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Document Has Been Signed on 05/11/2022 03:23 PM - It Cannot Be Edited


Created By: Jonathan Williams On 05/11/2022 at 03:04 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 & SARN, RANJODH
FACILITY NUMBER: 015700036

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/12/2022
Section Cited
HSC
1597.465(b)

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A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met:
(b) No more than three infants are cared for during any time when more than 12 children are being cared for.

This requirement was not met as evidenced by:
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Licensee shall reduce the number of children in care such that ratio requirements are met. Correction shall be verified via site visit.
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During today's visit, LPA observed 14 children in care, 5 of whom were infants. This poses an immediate risk to the health and safety of children in care.
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Failure to correct may result in civil penalty assessment.

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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:Jonathan Williams
LICENSING EVALUATOR SIGNATURE:
DATE: 05/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2022


LIC809 (FAS) - (06/04)
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