015700143-6-23-2023-52-CC-MPRE-CT3TNJ-20230623145249

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700143
Report Date: 06/23/2023
Date Signed: 06/23/2023 02:52:58 PM

Document Has Been Signed on 06/23/2023 02:52 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:	HASSAN GURUPRASAD, JYOTHI		FACILITY NUMBER:	015700143
ADMINISTRATOR:	HASSAN GURUPRASAD, JYOTHI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 784-2623
CITY:	FREMONT	STATE: CA	ZIP CODE:	94538
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 11	DATE:	06/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:46 PM
MET WITH:	Jyothi Hassan Guruprasad		TIME COMPLETED:	02:50 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 6/23/2023 at 12:46pm Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Jyothi Hassan Guruprasad for a Required – 1 Year Inspection. Present during the inspection was the Licensee, her adult helper, four (4) infants, and seven (7) preschool age children. Licensee lives in the home with her husband and their fourteen (14) year old daughter. The facility operates from 8:15am – 6:00pm, Monday - Friday. ON LIMITS AREA: Living Room, Sun Room, 1^st Bedroom on the right side of the hallway, Hallway Bathroom, and Backyard OFF LIMITS AREA: Kitchen, Master Bedroom and Bathroom, Second Bedroom, Garage, and Detached Room in the Backyard ISOLATION AREA: On-Limit Bedroom or Sun room The facility is a single-story home owned by the Licensee. The inside of the home is observed to be neat, clean with ample age-appropriate materials for the children. All toxins, cleaning products, personal medications, and hazardous materials were observed to be in inaccessible areas. Licensee has stated that there are no firearms and no pets in the home. The home has one (1) fully charged 2A10BC fire extinguisher in the closet by the front door. One (1) working smoke detector is in the living room, the bedroom and in the hallway. There is a working carbon monoxide detector in the hallway and one (1) working smoke/carbon monoxide detector in the sun room. The home is equipped with plenty of windows for proper ventilation and central heat. All napping equipment is clean, free from defects and properly maintained. There are two play yards for infants in the bedroom that were clean and properly maintained. Licensee provides all food for the children. All food that is brought from the children’s home will be properly labeled and stored. The fireplace in the living room is locked making it inaccessible to the children in care. Licensee stated that she does not transport children.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: HASSAN GURUPRASAD, JYOTHI	FACILITY NUMBER: 015700143
	VISIT DATE: 06/23/2023

NARRATIVE

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LPA did not observe any harmful bodies of water in or around the home. LPA observed four (4) infant rockers in the sun room. LPA informed Licensee that rockers were not to be used in home. Rockers were placed in an off-limit area during LPA’s inspection and will be removed from the home.

The backyard is fully fenced with ample age-appropriate materials for the children. Licensee uses the side gate leading to the backyard as the daycare entrance. There is a detached structure on the right side of the backyard that, per the homes fire clearance, is not to be used by the children in care. Licensee states that the room is used outside of operating hours and for storing the outside materials.

Licensee is operating within their licensed capacity and is in ratio. Licensee’s Health and Safety training with Lead Poisoning component has been completed and Pediatric CPR and First Aid training is completed and expires 5/14/2024. Licensee’s Mandated Reporter training is complete and expires 5/15/2025. All required forms are posted and visible for public view in the sun room by the entrance door. Fire drill log is complete with the last drill logged 2/15/2023. All adults living and working in the home have obtained a criminal record clearance. LPA obtained a sample of the children’s files, helper’s file, facility files, and facility roster. All files were complete.

Licensee was reminded that California Law requires 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 email. Licensee was reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting http://www.mandatedreporterca.com. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: HASSAN GURUPRASAD, JYOTHI	FACILITY NUMBER: 015700143
	VISIT DATE: 06/23/2023

NARRATIVE

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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.

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.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Exit interview conducted and report was reviewed with Licensee Jyothi Hassan Guruprasad.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

LIC809 (FAS) - (06/04)

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