434416723-10-6-2021-07-CC-SYIP-C7JLCB-20211006083805

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416723
Report Date: 10/05/2021
Date Signed: 10/06/2021 08:39:58 AM

Document Has Been Signed on 10/06/2021 08:39 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	SINGH, POOJA		FACILITY NUMBER:	434416723
ADMINISTRATOR:	POOJA, SINGH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 442-8503
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/05/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	03:04 PM
MET WITH:	Pooja Singh		TIME COMPLETED:	05:50 PM

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	Licensing Program Analyst (LPA) Samantha Yip conducted an announced pre-licensing inspection. LPA met with Applicant Pooja Singh and explained the reason for the inspection. The purpose of this inspection is Applicant is applying for a Large Family Child Care. Applicant has over one years of experience in a child care center thus the Applicant has over one years of experience that is required to apply for an increase to a Large FCCH. A fire clearance was granted on 07/20/2021. There is a board to post required postings, which include but not limited to Notification of Parents' Rights and Earthquake Preparedness checklist. Applicant owns the home and plan on obtaining daycare insurance. Applicant understands that she needs to use the Affidavit Regarding Liability Insurance to inform parents that she does not have a daycare insurance. Applicant plans on using her cell phone. The hours of operation are Monday through Friday 6AM to 6PM. LPA toured in inside and outside of the home. The off-limit areas of the home are the entire upstairs and the garage. An updated LIC 999A was obtained during today's inspection to reflect the changes to on-limits. There are stairs in the home, which are barricaded. LPA reminded Applicant that stairs need to be barricaded at all time. Applicant has an electric fireplace, which has a glass cover. All disinfectant, cleaning supplies, or other items that could pose a risk to children were inaccessible. LPA observed that there is sufficient amount of toys for the children. All furniture was observed to be in good condition and age appropriate. There were no baby walkers observed during today's inspection. Applicant understands that baby walkers and smoking not permitted in the home. There is fully charged fire extinguisher, smoke detector, and carbon monoxide detector. Applicant stated that there are no weapons, such as firearms, stored in the home. Applicant has a dog, who is up to date on their vaccines. ----------------------CONTINUES ON 809 DATED 10/05/2021 PAGE 2-----------------------------

SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SINGH, POOJA	FACILITY NUMBER: 434416723
	VISIT DATE: 10/05/2021

NARRATIVE

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--------------------CONTINUATION OF 809 DATED 10/05/2021 PAGE 1------------------------

The backyard is used and is fenced. LPA discussed with Applicant about plan for the air condition unit. Applicant stated that she plans on barricading the air condition unit. There were no bodies of water observed during today's inspection.

Applicant does not plan on transporting children, but understands that children cannot be left alone and unattended in parked vehicles. LPA discussed and provided updated car seat law.

The forms of discipline Applicant plans on using talking to the children and having a quiet area. Applicant understands that children's personal rights cannot be violated; including no corporal punishment.

LPA discussed the safe sleep regulations with Applicant 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 Applicant of the importance of checking 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 does plan on providing Incidental Medical Services (IMS). IMS policy was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. Applicant stated that she will submit Plan for Providing IMS to Licensing. 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 publications: Commonly Asked Questions about Child Care Center and the ADA, available at: http://www.ada.gov/childqanda.htm.

---------------------CONTINUES ON 809 DATED 10/05/2021 PAGE 3------------------------------

SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SINGH, POOJA	FACILITY NUMBER: 434416723
	VISIT DATE: 10/05/2021

NARRATIVE

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-----------------CONTINUATION OF 809 DATED 10/05/2021 PAGE 2---------------------------

Applicant does have a valid CPR/1st Aid, which expires on 12/19/2022. Applicant's certificate for Preventive Health and Safety, Mandated Reporter Training, and immunization records for measles, pertussis, and influenza are on file. Applicant completed the Mandated Reporter training on 05/10/2020. Applicant understands that Mandated Reporter training needs to be renewed every two years.

LPA provided Applicant with a Family Child Care Home packet with updated Licensing forms and reviewed with the Applicant. Department website: www. ccld.ca.gov provided to the Applicant. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, requirements for assistant/substitute, and immunization requirements for staff. LPA also discussed the requirements of the car seat law, healthy beverages in child care and zero tolerance violations with Applicant. LPA reminded Applicant/Licensee that fire/emergency drills need to be conducted every 6 months and documented. LPA discussed COVID guidelines with Applicant during today's inspection.

The adults living in the home are Applicant and her spouse. Applicant also has two minor children. All adults have cleared criminal record, child abuse index, or exemption, and TB clearance. Applicant was reminded that all adults 18 and over living or working in the home, 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.

Applicant stated that she will submit:
- Plan for Providing IMS

An exit interview was conducted where this report was discussed and provided to Applicant Pooja Singh. LPA advised Applicant that a license for a Large Family Child Care Home will be granted and issued upon review and approval of Licensing Program Manager.

SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021

LIC809 (FAS) - (06/04)

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