015700132-12-8-2023-52-CC-AWRT-CYC35E-20231208165637

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700132
Report Date: 12/08/2023
Date Signed: 12/08/2023 04:56:41 PM

Document Has Been Signed on 12/08/2023 04:56 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:	PRABAHAR, PARIMALAM		FACILITY NUMBER:	015700132
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 2	DATE:	12/08/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Parimalam Prabahar		TIME COMPLETED:	05:00 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 December 8th, 2023 at approximately 3:30pm, Licensing Program Analyst (LPA) April Wright met with licensee Parimalam Prabahar for an Unannounced Required 3 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the home by the licensee. LPA toured the facility to conduct a health and safety inspection. Present during inspection were two (2) school age children and fingerprint cleared Prabahar Murugaiyan. Hours of operation are 8:30am - 5:30pm Monday through Friday. The single story home consists of 4 bedrooms, 2 bathrooms including master bathroom, guest room, Living room, Dining Room, Kitchen, Backyard and garage. The home was neat and orderly, with heating and ventilation for safety and comfort of children in care. There is a fireplace in that is located in the dining area locked and inaccessible to children in care. On limit areas include: Sunroom (Daycare room) Guest Room (sick/isolation room), Family Room, Bathroom at the end of the hallway, Backyard Off-limits areas include: Living Room, Dining room, Master Bedroom with master Bathroom, remaining 2 Bedrooms, Kitchen and Garage. Isolation Room: Guest Room The off limits area will be made inaccessible by closed and/or locked doors and visual supervision. There are no pools hot tubs or any other bodies of water present in the home or during inspection. LPA did not observe any toxins, chemicals or hazardous materials present during inspection. There are age appropriate toys that appear to be safe and in good condition. The home has a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detector, fully stock First Aid Kit and telephone. Per licensee there are no weapons or firearms in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers. See LIC809 -C for continuance

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023

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: PRABAHAR, PARIMALAM	FACILITY NUMBER: 015700132
	VISIT DATE: 12/08/2023

NARRATIVE

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LPA requested and reviewed the two (2) files of children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The facility roster was review and copies were obtained. The facility roster was review and copies were obtained. The licensee conducts fire and disaster drills twice a year and the last was conducted on 10/9/2023. CPR/First aid certificate was completed and expires 11/12/2024 and Mandated Reporter training was completed on 8/3/2022. The licensee is in ratio today. All required forms are posted and visible for public review.

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.

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/

See LIC809C for continuance.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023

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: PRABAHAR, PARIMALAM	FACILITY NUMBER: 015700132
	VISIT DATE: 12/08/2023

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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 Parimalam, 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 Parimalam Prabahar.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023

LIC809 (FAS) - (06/04)

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