434417095-6-14-2024-07-CC-MKAR-D68SG8-20240614135132

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417095
Report Date: 06/14/2024
Date Signed: 06/14/2024 01:51:42 PM

Document Has Been Signed on 06/14/2024 01:51 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 JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	PONNAGANTI, SHILPA		FACILITY NUMBER:	434417095
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 6	DATE:	06/14/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:55 AM
MET WITH:	Shilpa Ponnaganti		TIME VISIT/ INSPECTION COMPLETED:	02:15 PM

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Licensing Program Analyst (LPA), Mandeep Kaur conducted an unannounced Case Management- Licensee Initiated inspection with Shilpa Ponnaganti, Licensee. The purpose of today's inspection: address the Application for a Large Family Child Care Home license (Capacity Change) that the Licensee submitted to the Department on May 03, 2024. Licensee is currently licensed for Small Family Child Care Home (FCCH). Licensee has been licensed since 05/26/2023; therefore, she has at least one year of experience as a family child care provider to apply for a Large FCCH. A fire Clearance for Large Family Child Care Home was granted on 05/23/2024.

LPA observed that 6 children were present in the home during today’s inspection. Licensee stated that she, her husband and 2 children (nine year and thirteen year old) are residing in the home. Days and hours of operations are Monday to Friday from 8:30 AM to 6:00 PM. The Licensee completed the Preventative Health and Safety Child Care Training on 03/11/2023 and a copy of the certification is on file. The Licensee has proof of Pediatric CPR and First Aid training completed on 02/26/2023, on file. A copy of current TB test, flu, MMR, and Tdap vaccinations for the Licensee are on file. Proof of completion of the Mandated Reporter Training for Child Care Workers completed on 03/11/20/23, is on file. LPA reminded licensee that the Mandated Reporter training and CPR/1st Aid requires renewal every two years.

The Licensee rents this double story 2 bedrooms and two bathrooms town home. The Licensee has childcare liability insurance valid until 3/082025. The copy of the childcare liability insurance was obtained during the inspection. All individuals subject to a criminal record review have obtained a criminal record and child abuse index clearances prior to today's inspection.

The Licensee agreed to give LPA a tour of the home (indoor/outdoor) during today's inspection.

LPA observed the indoor and outdoor areas of the home. There is a working telephone in the home. The home is clean and orderly, with heating and ventilation for safety & comfort.

**Continue on next page**

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024

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

FACILITY NAME: PONNAGANTI, SHILPA	FACILITY NUMBER: 434417095
	VISIT DATE: 06/14/2024

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**Continuation from 809**

LPA observed no fireplace and no wall heaters. The off-limit areas inside the home are: kitchen and second floor with 1 bedroom and a bathroom. LPA observed the barricaded gate at the bottom of the stairs to the second floor. Outdoor offlimit areas are: a section of the backyard with an emergency exit route for children if needed in the future. Daycare areas are living room, dining room, downstairs bathroom, master bedroom(second floor), and backyard. There are safe and age-appropriate toys, play equipment, and materials for the children in the home. The Licensee has a designated area in the home( a part of the living room) where children can be isolated if exhibiting signs of illness. The home has at least 1 working smoke and carbon monoxide detector in the home. The Licensee has one fully charged fire extinguisher (2A10BC) inside the home. The Licensee states she does not have any pets or weapons in the home. All cleaning compounds and medications are adequately stored (locked cabinets) inaccessible to children. LPA reminded Licensee that smoking, baby walkers, bouncers, jumpers, and similar items are not allowed in Family Child Care Homes. The licensee has a first aid kit in the home, with sufficient emergency supplies, including a no-touch thermometer.

Kitchen tour: LPA observed the refrigerator and freezer in the home are clean. All disinfectant, cleaning supplies, and other items that could pose a risk to children were inaccessible. The Licensee provides the food and understands that food and any bottles served to the children need to be labeled with their names. The Licensee understands that any food/drink which is brought by parent(s) of day care child(ren) must be properly labeled with the child(ren) name and properly stored or refrigerated.

LPA discussed the Healthy Beverage requirements with licensee.

Bathroom tour: LPA observed the bathroom toilet and faucet are clean, safe, and operable. All shampoos, soap, medication, mouthwash, perfumes, razors, cleaning products, air fresheners, and nail polish/remover are inaccessible to the children.

Outdoor tour: LPA observed the outdoor backyard of the home is fenced, safe, and secure for the children. There are no bodies of water in the backyard. Licensee was advised that outdoor play shall be supervised at all times.

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SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024

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

FACILITY NAME: PONNAGANTI, SHILPA	FACILITY NUMBER: 434417095
	VISIT DATE: 06/14/2024

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**Continuation from 809-C**

Forms of discipline to be used by Licensee: talking to children and redirecting. The Licensee understands that children's personal rights should not be violated; including no corporal punishment, supervision of children, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed with the Licensee during today's inspection.

This facility plans to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Licensee 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.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep
as an additional resource. LPA also informed Licensee 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.

**Continue on 809-C**

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024

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

FACILITY NAME: PONNAGANTI, SHILPA	FACILITY NUMBER: 434417095
	VISIT DATE: 06/14/2024

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**Continuation from 809-C**

On this date, 05/06/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

LPA discussed the Large Family Child Care Home Ratio and Forms/Records to Keep in Large Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

The licensee has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, the licensee understands that, once licensed, they can operate with a maximum capacity of 12 children. If property owner/landlord consent is obtained in the future, the licensee is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 14 children.

Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families
obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs)
throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and
stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other
important information communication platforms.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information
website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child
Care option to receive email communication.

Exit interview conducted and report was reviewed with Licensee Shilpa Ponnaganti. LPA advised Licensee that Large Family Child Care Home license with the maximum capacity of 12 children, will be issued upon completion of the following:

1. Licensing Program Manager (LPM) review and approval.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024

LIC809 (FAS) - (06/04)

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