015701009-11-28-2023-52-CC-JSAI-CXZR4C-20231128114116

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015701009
Report Date: 11/28/2023
Date Signed: 11/28/2023 11:41:21 AM

Document Has Been Signed on 11/28/2023 11:41 AM - 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:	TUMU, NAVITHA		FACILITY NUMBER:	015701009
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	11/28/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Applicant, Navitha Tumu		TIME COMPLETED:	12:10 PM

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Licensing Program Analyst (LPA) Jyoti Saini conducted a scheduled pre-licensing inspection this day, arriving at 9:00 am and met with Applicant Navitha Tumu. LPA and Applicant inspected an entire home for Health and Safety Hazards. Applicant owns this property. The applicant lives in this home with husband and two minor children. The home consists of a living room, dining room, four bedrooms including master bedroom attached bathroom, hallway bathroom, hallway closet, kitchen, front yard, and backyard. Per applicant, family childcare’s operating hours will be from Monday-Friday 8:00am-6:00pm.

ON LIMIT AREAS : the dining room, kitchen, living room (main day care area) bathroom #1 located on the left side of the hallway and backyard.

OFF LIMIT AREAS : All the bedrooms and bathroom #2, front yard and garage.

The home appears to be neat and clean with heating and ventilation for safety and comfort. The ISOLATION AREA will be the living room. All off limit areas are properly barricaded. Home has a working smoke and carbon monoxide detector, a working telephone, and a fully charged Fire Extinguisher. There are no pools, hot tubs, or any other bodies of water on the premises. All hazardous materials and toxins are kept out of the reach of children. All bathroom/kitchen cabinets are latched to prevent children from access. The applicant will be providing lunch and snacks. Applicant states discipline policy is redirection. Per Applicant, she may or may not purchase liability insurance, she was advised to use form, the Affidavit regarding liability insurance for FCCH. Parent's Right and the Emergency Disaster Plan were Posted. Applicant was advised to post the License when she received it. Applicant was also advised to conducts fire/disaster drills once every six months, and to log the date and time of the drill. LPA discussed safe sleep guidelines and 15 minutes check requirements.

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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

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: TUMU, NAVITHA	FACILITY NUMBER: 015701009
	VISIT DATE: 11/28/2023

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The applicant Health and Safety training is completed, and CPR and First Aid certificate is current and expires 02/2024. The fireplace in the house is used as storage for electric devices and fully latched. The applicants mandated reporter training is complete. Applicant is reminded of NO walker, exersaucers, jumpers, bouncers, and any similar items to be used for children in care and shall be made inaccessible. Smoking is prohibited in family childcare homes. The Applicant is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

Applicants was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

The applicant owns the home and provided proof of control of property.

APPLICANT KNOWS PROSPECTIVE CLIENTS WILL NEED IMS:
This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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

Review of records to be maintained - Family Childcare Homes
LPA reviewed with applicant the LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

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: TUMU, NAVITHA	FACILITY NUMBER: 015701009
	VISIT DATE: 11/28/2023

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Safe Sleep -Family Child Care Homes
LPA discussed the safe sleep regulations with applicant 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 [applicant, licensee, or facility representative] 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.

Applicant was informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication

Small family Child Care Home license is recommended effective 11/28/2023

Exit interview conducted and report was reviewed with the applicant, Navitha Tumu.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

LIC809 (FAS) - (06/04)

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