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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073404456
Report Date: 07/22/2021
Date Signed: 07/22/2021 12:15:54 PM

Document Has Been Signed on 07/22/2021 12:15 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:GREWAL, BAKSHOFACILITY NUMBER:
073404456
ADMINISTRATOR:GREWAL, BAKSHOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 838-0201
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
07/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Baksho GrewalTIME COMPLETED:
12:25 PM
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On July 22, 2021 a 10:35am, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced for a Required-1 Year Inspection, and met with Licensee Baksho Grewal. Also residing in the home are the licensee's husband, son, mother-in-law and father-in-law. Present for this inspection were 10 preschool age children and helper Devika Raghu. All adults have proper fingerprint clearances. The home was toured to conduct a health and safety inspection. Current hours of operation for day care are Monday through Friday, 9:30am to 12:30pm.

ON LIMITS: Entire first floor, backyard.

OFF LIMITS: Entire second floor, in-law unit, garage. Off limit areas are inaccessible by closed and/or locked doors and visual supervision. Licensee is aware she must contact Licensing, so that an inspection can be completed prior to changing an off limits area to on limits.

The home is two story, which is neat and clean, with heating and ventilation for safety and comfort. The stairway had a child safety gate in place. The outdoor play area is fenced, and free from defects and dangerous conditions. There is a separate in-law unit in the back above the garage. There were ample age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. Fire extinguisher, carbon monoxide and smoke detector meet State Fire Marshall standards. Per licensee, the wood burning fireplace is never used during day care hours. Per licensee, there are no firearms in the home. The licensee conducts and documents Fire/Disaster Drills regularly, and the log indicates a drill was conducted 5/18/21. Licensing documents are posted and visible for public review, and a copy of the Earthquake Preparedness Checklist and car seat laws were provided.

***Continued on LIC 809C....
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE: DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2021
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: GREWAL, BAKSHO
FACILITY NUMBER: 073404456
VISIT DATE: 07/22/2021
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At 11:20am, children's files were reviewed and found to be complete. The facility roster was reviewed, and a copy obtained. The licensee is in ratio today. The licensee's Pediatric CPR/First Aid certificate is current and expires 11/9/21. Licensee and helper Devika are in compliance with the immunization law which pertains to day care providers. Licensee's mandated reporter training expires 9/1/21, and Devika's expires 5/24/23. Safe Sleep regulations were discussed. Licensee was reminded that children are never to be left in a parked vehicle.

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 is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

Licensee is advised to submit updated Emergency Disaster Plan (LIC 610A) within 10 days.

There were no deficiencies cited during today's inspection. This report shall remain on file for 3 years. A Notice of Site visit was provided at time of inspection and must remain posted for 30 days.

Exit interview conducted with Baksho Grewal. Copy of report and appeal rights provided.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
LIC809 (FAS) - (06/04)
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