073409412-6-14-2023-02-CC-MMAR-CSSPJ7-20230614112105

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409412
Report Date: 06/14/2023
Date Signed: 06/14/2023 11:21:14 AM

Document Has Been Signed on 06/14/2023 11:21 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	BATTSOOJ, BURENJARGAL		FACILITY NUMBER:	073409412
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 2	DATE:	06/14/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Burenjargal Battsooj		TIME COMPLETED:	11:45 AM

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 6/14/23 Licensing Program Analyst (LPA), Monica Mathur conducted an announced Prelicensing Inspection at Burenjargal Battsooj's home and met with the Applicant, Burenjargal. Present during inspection was Applicant and two nephews (16 year old). Applicant stated they were visiting for a day. Applicant lives in the home with her spouse and 2 children (ages 19 months and 4 years). She understands that her children will count in ratio when present at home. Applicant has applied for a Small Family Child Care Home with capacity for eight (8) children and will be offering Overnight Care. LPA reminded her that overnight care can be provided for no more than 23 hours at a stretch. Burenjargal states she will operate all 7 days of the week Monday-Sunday from 8:00am-5:30pm and overnight care from 7:00pm-6:00am. Applicant has completed the 16-hour Health & Safety Training which includes Pediatric CPR and First Aid, has documentation for Measles, Pertussis Immunizations, Influenza Opt Out for the current flu season and Tuberculosis (TB) clearance. Applicant rents the home and submitted a copy of the Rental Agreement. LPA reminded Applicant that when care for more than six and up to eight is provided, Applicant must notify Parents and get Landlord Consent on LIC9149. Applicant will get Liability Insurance. Her spouse will be an employee/helper and has all required documentation on file. Indoor Space: Home is single story. LPA toured the indoor space which consists of Living room, Kitchen/Dining area, Family room, 4 Bedrooms, 2 Bathrooms, attached Garage, Laundry area. ON LIMIT: Living room, Family room, Front entrance area, Hallway Bathroom and Garage (for activities only). Applicant was reminded that Garage can only be used as activity/play area, and not for naps or eating. At drop off parents will walk their child through the side yard gate, into the Garage/Activity room. OFF LIMIT: Living room, Kitchen/Dining area, all 4 Bedrooms, Master Bathroom, Laundry area and Water Heater closet in garage

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BATTSOOJ, BURENJARGAL	FACILITY NUMBER: 073409412
	VISIT DATE: 06/14/2023

NARRATIVE

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Applicant plans to offer overnight care and will use Family room for sleep purpose. LPA discussed overnight care regulations and requirements. Applicant will submit a written plan for overnight care. The home is sanitary, safe and orderly, with central heating and ventilation for safety and comfort. LPA observed required postings on the wall. There is a screened fireplace and no stairs inside the home. LPA observed: fully charged fire extinguisher in the garage, working smoke and carbon monoxide detectors. Medicines, cleaning products, sharp objects are stored inaccessible to children in cabinets. LPA reminded Applicant that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. Applicant states there are no firearms or ammunition stored in the home.

Outdoor Space: ON LIMITS: Entire Backyard

OFF LIMITS: Side Yard. Parents will escort child through side yard during drop off/pick up. Backyard is fenced and large play structure is anchored to the ground. Observed loose wires near garage door into backyard which could pose a safety threat. Applicant will manage the wires, make it inaccessible and send proof of correction.

Discipline policy was discussed, and Applicant stated she will talk to the children as form of discipline. Applicant understands that children's personal rights should not be violated and no corporal punishment. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries and requirements for assistant/substitute were also discussed. Fire drills must be practiced once every six months and documented. Supervision of children was discussed with the Applicant and she understands that she must be present in the home during 80% of the operating hours of the day care and ensure that the children are supervised at all times. The Licensee understands her capacity options and that she cannot have more than 8 children in the home at any time. Applicant may offer transportation services for children drop off and pick up. Prior approval is required when an off-limit area needs to be added to day care use.

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. A Family Child Care Home packet was provided to the Applicant.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BATTSOOJ, BURENJARGAL	FACILITY NUMBER: 073409412
	VISIT DATE: 06/14/2023

NARRATIVE

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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: http://www.ada.gov/childqanda.htm

LPA discussed the Safe Sleep regulations with Applicant, and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Applicant 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 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, 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.

Website links for provider resources:

Licensing forms, Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov.

The following documents need to be submitted prior to issue of license - NO LATER THAN 6/21/23
1. Backyard - manage loose wires near garage door, send photo
2. Overnight Plan of Operation
Facility is recommended for license, subject to final approval by Management. Exit interview conducted and report was reviewed with the Applicant, Burenjargal Battsooj.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

LIC809 (FAS) - (06/04)

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