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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627649
Report Date: 07/21/2021
Date Signed: 07/21/2021 02:05:45 PM

Document Has Been Signed on 07/21/2021 02:05 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CHITTARI MACHAROUTHU, USHA RANI FAMILY CHILD CAREFACILITY NUMBER:
376627649
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
07/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Usha Rani Chittari Macharouthu and Narasimha KrishnaTIME COMPLETED:
02:10 PM
NARRATIVE
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(1) On 07/21/2021 at 11:50AM, Licensing Program Analyst (LPA) Selina Siao conducted an unannounced random inspection with the Licensee. The home was toured and inspected to ensure an environment safe for the care and supervision of children. Present at the facility were the Licensee, her husband Narasimha Krishna and their two daughters are also in their off limit bedrooms. Licensee is caring for four day care children. The home has a fully charged fire extinguisher size 3A40BC, smoke and carbon monoxide detector that meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Licensee stated that there are no bodies of water or weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances. Licensee and her husband Narasimha Krishna have an EMSA approved First Aid and CPR certifications that are current due to expire on 01/2023. Applicant stated that her and her husband has not renew their online mandated child abuse training. Children’s records were reviewed and all children has the identification and emergency form on record. Facility did not have a roster available. Licensee last conducted a drill with the children in care on 01/25/2021.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include living room, dining area and bathroom. Off limits areas include the kitchen, garage, bedroom #1, bedroom #2 and master bedroom and bath which are inaccessible by closing the door. There is a safety gate to prevent children access to the kitchen. LPA advised licensee that door knob covers or safety gates shall be use for the off limit bedrooms. The facility has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities and visual supervision is needed when children are outside.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2021
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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Document Has Been Signed on 07/21/2021 02:05 PM - It Cannot Be Edited


Created By: Selina Siao On 07/21/2021 at 01:26 PM
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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CHITTARI MACHAROUTHU, USHA RANI FAMILY CHILD CARE
FACILITY NUMBER: 376627649

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2021
Section Cited
CCR
102417(g)(8)

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Operation of a Family Child Care Home: Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement is not met as evidence that facility does not have a roster.

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Licensee's husband completed an updated roster during the inspection.
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Type B
08/20/2021
Section Cited
HSC1596.8662(4)(b)(1)

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated
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Licensee and her husband stated that they will complete the online mandated child abuse training and will submit the certificate to Analyst no later than 08/20/2021.
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reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidence by that licensee and her husband does not have a current mandated child abuse training certificate available for review.
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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:Monica Cuddy
LICENSING EVALUATOR NAME:Selina Siao
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2021


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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CHITTARI MACHAROUTHU, USHA RANI FAMILY CHILD CARE
FACILITY NUMBER: 376627649
VISIT DATE: 07/21/2021
NARRATIVE
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Per Senate Bill 792 pertaining to immunizations, which require all licensee, helpers in daycare operation to have proof of immunizations for; Measles, Pertussis and Influenza. Licensee and her husband both have the required immunizations.

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

The following items were discussed with provider: Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. Licensee will be provided with information via email about Heat Related Illness, Sudden Infant Death Syndrome (SIDS), Never Shake a Baby, safe sleep for infants, best practice on supervision, latest car seat poster and effects of lead exposure and reporting responsibilities were discussed. The ABC’S of Safe Sleep: Sleep is Safest: Alone, on their Back in an empty Crib on a firm mattress.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website www.ccld.ca.gov to receive important updates. LPA discussed California Megan's Law with provider www.meganslaw.ca.gov.

See LIC809D for deficiencies:

A Notice of Site Visit was posted during the inspection and it must remain posted for a period or 30 days. Failure to keep notice posted will result in a civil penalty of $100.00. Provided appeal rights to licensee today.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC809 (FAS) - (06/04)
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