393621011-2-14-2024-53-CC-SWIS-D2FRBD-20240214115234

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393621011
Report Date: 02/14/2024
Date Signed: 02/14/2024 11:52:41 AM

Document Has Been Signed on 02/14/2024 11:52 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	KAIRAMKONDA, SARITHA		FACILITY NUMBER:	393621011
ADMINISTRATOR:	KAIRAMKONDA, SARITHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 281-2133
CITY:	MOUNTAIN HOUSE	STATE: CA	ZIP CODE:	95391
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 11	DATE:	02/14/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:37 AM
MET WITH:	Saritha Kairamkonda		TIME COMPLETED:	12:00 PM

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On February 14, 2024, Licensing Program Analyst (LPA) Stacey Williams met with Licensee, Saritha Kairamkonda for an unannounced 3-Year inspection. During the inspection, LPA observed eleven children in care being supervised by the Licensee and two Assistants. All individuals subject to criminal background review have obtained a criminal record clearance. Hours of operation are Monday – Friday from 8:30AM-5:30PM. Licnesee stated that she does not provide overnight care.

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.

The facility is a two -story home. Off-limits areas include: entire upstairs and the garage and first floor bedroom. Licensee stated there are no weapons in the home. The backyard is fenced and utilized for outdoor play. There are no bodies of water on the property. Licensee stated there is an outdoor pet rabbit in the home that occasionally interacts with children in care.

LPA conducted a health and safety inspection in the areas accessible to children. The house has a working telephone, fully charged fire extinguisher, smoke detector and carbon monoxide detector that meet regulations. LPA observed all the required postings are in an area visible to authorized representatives. LPA observed all poisons are inaccessible to children in care. There is an electric fireplace in the home which Licensee states is not in use during childcare hours.

After reviewing the facility files, LPA found that required immunization records are missing for staff. TDAP clearance and MMR immunizations for Assistant #1 and Assistant#2 and TB clearance for Assistant #2. Mandated Reporter Training is current for Licensee and both Assistants. CPR certification is on file. Licensee’s CPR/First Aid expiration date is 2/2024. Licensee understands that CPR/First Aid and Mandated reporter trainings must be renewed every two years. LPA observed that all children's files contained appropriate documentation. Children's roster is current. Fire drill logs were observed; the last drill was conducted 11/2023.

Report continues on LIC 809C................

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024

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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KAIRAMKONDA, SARITHA	FACILITY NUMBER: 393621011
	VISIT DATE: 02/14/2024

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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: https://www.ada.gov/resources/child-care-centers/.

LPA discussed 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-and-resources/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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare 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.cdssca.gov/inforesources/community-care-licensing/inspection-process.

Title 22 deficiencies were observed during today’s inspection and will be cited on subsequent page, LIC 809D.

Exit interview conducted and report was reviewed with the Licensee, Saritha Kairamkonda.

Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/14/2024 11:52 AM - It Cannot Be Edited

Created By: Stacey Williams On 02/14/2024 at 11:42 AM

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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KAIRAMKONDA, SARITHA	FACILITY NUMBER: 393621011
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

Administration of Child Day Care Licensing

(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 out of 2 files reviewed which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/14/2024
	Plan of Correction
1 2 3 4	Licensee will ensure that all staff have current immunization records on file. Immunization records shall include: MMR, TDAP, TB and influenza (optional/ declaration must be on file) by POC date .

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Bettina Engelman

LICENSING EVALUATOR NAME:

Stacey Williams

LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024

LIC809 (FAS) - (06/04)

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