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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627710
Report Date: 08/06/2024
Date Signed: 08/06/2024 12:10:55 PM

Document Has Been Signed on 08/06/2024 12:10 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:DEBNATH, MOUMITA FAMILY CHILD CAREFACILITY NUMBER:
376627710
ADMINISTRATOR/
DIRECTOR:		MOUMITA DEBNATHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 728-6560
CITY:SAN DIEGOSTATE: CAZIP CODE:
92131
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
08/06/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Moumita DebnathTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 8/6/24 at 9:30 am Licensing Program Analyst (LPA) Gerald Poindexter conducted an unannounced annual inspection. Upon arrival, LPA met with licensee Moumita Debnath. Present in the home were 14 day care children, none under 24 months. Also, present was the licensee two helpers: Lakshmi Konakanchi and Laxmi Alavalli. The licensee was provided with the Inspection Checklist (LIC 126). The three-bedroom, loft space, three-bath, two-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Licensee states hours of operation are typMonday-Friday, 8:30 am to 5:00 pm.

The licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include: family room, living room, bathroom, and backyard. Off limits areas include: All upstairs and garage, which are made inaccessible through use of safety gates and locks. The facility has sufficient toys and equipment available.

The licensee uses the fenced backyard for outdoor play area. LPA observed all areas of the backyard and the licensee stated that she understands that visual supervision is always required during outdoor activities. Licensee stated that there are no bodies of water on the premises and LPA did not observe any bodies of water. There is a fully charged fire extinguisher, smoke detector, and carbon monoxide detector that meet requirements and are operational. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children due to safety gates and high placement. Adequate heating and ventilation are provided. There is a working telephone and email address. Licensee advised there are no firearms or ammunition stored on the premises.

LPA observed all required postings were posted. Licensee maintains a current roster of the children which LPA obtained during time of inspection. Children’s records were reviewed and found to be in order. Staff records were reviewed. Preventative health practices course was completed, which includes lead poison prevention training. CONTINUED ON PAGE 2

SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: DEBNATH, MOUMITA FAMILY CHILD CARE
FACILITY NUMBER: 376627710
VISIT DATE: 08/06/2024
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Licensee and helpers have the required immunizations per SB792. Licensee’s Pediatric CPR/First Aid is current with an expiration date of 1/27/26. Ms. Konakanchi’s and Ms. Alavalli’s both expire 8/26/25. Licensee’s Mandated Reporter Training Certificates per AB1207 expires, 4/3/26. Ms. Konakanchi’s expires 5/28/26 and Ms. Alavalli’s expires 9/22/26. LPA reminded licensee that Pediatric CPR/First Aid and Mandated Reporter Training Certificates must be renewed every 2 years.

Emergency drills are conducted and documented with the last one being on 3/5/24. LPA verified that all adults living or working in the home have been fingerprint cleared and associated. LPA reminded Licensee that all unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619)767-2203. Duty officer number is (619) 767-2248. Licensee was reminded that all adults 18 and over living or working in the home, 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.



LPA conducted child care quality management staff interview with the licensee. 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-andresources/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. 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: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: DEBNATH, MOUMITA FAMILY CHILD CARE
FACILITY NUMBER: 376627710
VISIT DATE: 08/06/2024
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Licensee was informed of the MyChildCarePlan.org website; 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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

No deficiencies cited



Exit interview conducted and report was reviewed with the licensee Moumita Debnash. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2024
LIC809 (FAS) - (06/04)
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