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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700337
Report Date: 07/29/2022
Date Signed: 07/29/2022 11:34:34 AM

Document Has Been Signed on 07/29/2022 11:34 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ARA, ROSHANFACILITY NUMBER:
435700337
ADMINISTRATOR:ARA, ROSHANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 464-1659
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
07/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:08 AM
MET WITH:Roshan AraTIME COMPLETED:
12:00 PM
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On Friday, July 29, 2022 4:11 AM, Licensing Program Analyst (LPA) Manel Estoesta conducted an announced Required 1 Year Visit. LPA met with the Licensee Roshan Ara and explained the nature of site visit. Present on this visit were Licensee's Spouse, Licensee's Assistant, Licensee's Assistant's school age daughter, Licensee's 2 son (preschool and school age), 1 infant child and 5 preschool children. The home operates from Monday to Friday 8:30am to 6pm.

LPA toured the home to conduct a Health and Safety Inspection. The home is a single-story home with 4 bedroom and 2 bathrooms. The home is neat and clean with central heating and ventilation for safety and comfort. The home does have a fireplace that is screened to prevent access to children.

The ON-LIMIT AREAS are the family room (next to the garage), sunroom, and the master bedroom (music room) and master bathroom and the backyard.

The OFF-LIMIT AREAS are the living room, dining area, kitchen, hallway bathroom, bedroom number 1, 2, 3 and the garage will be inaccessible to children by locked doors, safety gates and visual supervision. There is a safety gates located in the home to prevent access to the OFF-LIMIT AREAS.

The designated isolation area will be living room. The backyard will be a designated outdoor play area that is fully fenced. The outdoor area has age appropriate toys that appear to be clean and free from defects and dangerous conditions. There are no pools, hot tubes or any other bodies of water. All hazardous materials and toxins are kept out of reach from children and are not accessible. The home has a fully charged fire extinguisher 3A40BC, working smoke detector, carbon monoxide, mobile phone and fully stocked first aid kit. Per licensee, there are no firearms on the premises. the licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 03/22/2022. The Licensee owns the home and maintained LIC 282 in each child's file.

SEE 809 C.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ARA, ROSHAN
FACILITY NUMBER: 435700337
VISIT DATE: 07/29/2022
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The licensee CPR and First Aid certificate and expires on 05/08/2023. The licensee completed the Mandated Reporter General Training and Child Care Providers training online at https://mandatedreporterca.com/ on 08/26/2021. Licensees have records of Measles and Pertussis immunization, Influenza vaccination and TB clearance. LPA reminded Licensee that only the Influenza vaccination can be decline with a written declination.

Facility roster of children was reviewed, and a copy was obtained. Children’s files were reviewed, which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, and Immunization. The licensee is in ratio today.

Licensee stated that she does not transport children at this time. Licensee has a current and valid Driver License. Licensee understands that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children in care shall be maintained in safe operating conditions and all vehicle occupants must be secured in an appropriate restraint system.

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



LPA discussed the following;
*PIN 20-24-CCP RECENTLY APPROVED SAFE SLEEP REGULATIONS IN EFFECT, PIN 22-10-CCP UPDATED GUIDANCE FOR CHILD CARE PROVIDERS REGARDING CORONAVIRUS DISEASE (COVID-19) and Provider Information for Parents & Families about Lead Poisoning and reminded that licensee must provide the Risks and Effects of Lead Poisoning PUB 515 flyer to parents and families upon enrolling or reenrolling any child.

SEE 809 C.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ARA, ROSHAN
FACILITY NUMBER: 435700337
VISIT DATE: 07/29/2022
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Continuation.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

Licensee 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.

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-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

There are no deficiencies cited on this visit.

A 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.

Exit interview conducted and report was reviewed with the licensee, Roshan Ara.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022
LIC809 (FAS) - (06/04)
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