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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700202
Report Date: 11/16/2022
Date Signed: 11/16/2022 12:18:00 PM

Document Has Been Signed on 11/16/2022 12:18 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:BHARATI, SONI KUMARIFACILITY NUMBER:
015700202
ADMINISTRATOR:BHARATI, SONI KUMARIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 516-7006
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
11/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Soni Kumari BharatiTIME COMPLETED:
12:30 PM
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On 11/16/2022 approximately at 9:00AM Licensing Program Analyst (LPA) Kelly Phan arrived at for an unannounced required inspection, and met with Licensee Soni Kumari Bharati. Present for this inspection was licensee, licensee's fingerprinted and associated husband, 2 infants, and 6 preschool aged children. The licensee is in ratio today. Also residing in the home is the licensee's husband, fingerprinted and associated mother, and their two children (6 & 2). The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8:00am to 6:00pm.

ON LIMITS: living room, fully fenced backyard, dining room, main day care area ("hall and pantry" on facility sketch), and bathroom in the main day care area
OFF LIMITS: garage, kitchen, 2 bathrooms, all 3 bedrooms. Off limit areas are inaccessible by closed and/or locked doors, gates, and visual supervision.

The home is single story, which is neat and clean, with heating and ventilation for safety and comfort. A door is used to keep children in the main day care room area. There were age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. There is a fully charged 3A40BC fire extinguisher, working dual carbon monoxide and smoke detectors, and telephone. LPA did not observe a fireplace at the facility. Per licensee, there are no firearms or pets or any bodies of water in the home. Children are sleeping on mats with a fitted sheet; per licensee, bedding and blankets are given to parents to clean every Friday. At 9:45AM, LPA toured the backyard area and found that it is safe as there is grass that absorb any falls; both side yards have secure barrier and have a swing set that is properly anchored to the ground. A fire drill log indicates a drill was last conducted on 05/18/22. All required licensing documents are posted and visible for public review.

SEE LIC 809 C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2022
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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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: BHARATI, SONI KUMARI
FACILITY NUMBER: 015700202
VISIT DATE: 11/16/2022
NARRATIVE
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At 10:00AM, 6 random children's files were reviewed and found that there are immunizations present, however it is not documented on required California blue immunization forms. The facility roster was reviewed, and a copy obtained. Licensee and her helper have proof of the required immunization. The licensee and her helper have required mandated reporter training that is completed as of 12/19/2020 and her helper had completed on 11/17/2021; licensee was reminded to renew trainings every 2 years. CPR and First Aid training are also valid from 03/26/2022 to 3/26/2024 for her helper and licensee has CPR and first aid valid from 11/12/22 to 11/12/2024. LPA also advised licensee to obtain LIC 9052 (Employee Rights form) completed for her helper as she is now considered as an employee. LPA also reviewed sleep logs for her newly enrolled infant and reminded licensee to continue to conduct and document sleep checks for children up to 2 years old.

There were 2 deficiencies were cited for today's inspection
1 Type B - all children's immunizations need to be documented on California blue form
1 Type B - LIC 9227 (Infant Sleeping plan) was not present in 3 children files, SEE LIC 809D

Appeal rights and 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 $100.00. Exit interview conducted and report was reviewed with licensee Soni Kumari Bharati.

SEE LIC 809 C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
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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: BHARATI, SONI KUMARI
FACILITY NUMBER: 015700202
VISIT DATE: 11/16/2022
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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.


Incidental Medical Services (IMS) policy was discussed. This facility is providing IMS to children in care. 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.


Licensee was reminded that California Law requires licensed Child Care Centers 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 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the Facility Representative that all forms can be downloaded at www.ccld.ca.gov and encouraged the Facility Representative to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

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.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/16/2022 12:18 PM - It Cannot Be Edited


Created By: Kelly Phan On 11/16/2022 at 11:26 AM
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: BHARATI, SONI KUMARI
FACILITY NUMBER: 015700202

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(g)(1)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above as all six children files did not have immunizations documented on California blue form, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/30/2022
Plan of Correction
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Licensee will send corrections to LPA before or by 11/30/2022 via email
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above during a file review of the six children files, 3 children files did not have LIC 9227 who are considered infants, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/30/2022
Plan of Correction
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Licensee will send corrections to LPA before or by 11/30/2022 via email
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:Kelly Phan
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2022


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