435700386-9-8-2023-52-CC-MESA-CVGVYU-20230908165144

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700386
Report Date: 09/08/2023
Date Signed: 09/08/2023 04:53:00 PM

Document Has Been Signed on 09/08/2023 04:53 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	PATEL, VIMU		FACILITY NUMBER:	435700386
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	09/08/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Vimu Patel		TIME COMPLETED:	03:15 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	On Friday, September 8, 2023, at 12 PM, Licensing Program Analyst (LPA) Manel Estoesta conducted an announced Pre-licensing Visit. LPA met with the Applicant Vimu Patel and explained the nature of site visit. Present on this visit were the Applicants Spouse and Applicants preschool child. The applicant submitted a Family Child Care Home (FCCH) Small License Application and received in the Regional Office on 07/21/23. The home plans to operate from Monday to Friday 8:30 am to 6:30 pm. LPA toured the home to conduct a Health and Safety Inspection with the Applicant. The home is a one-story home. The home is neat and clean with central heating and ventilation for safety and comfort. The On-Limit Areas are the Family Room (Day Care Room), Living Room, Kitchen, hallway bathroom and the Napping Room, adjacent to the Master Bedroom and Office Room. The Family Room will be a designated play area. The Living Room is the designated Isolation Area when a child gets sick. The home does have a fully charged 2A10BC fire extinguisher. The home has a working smoke detector and carbon monoxide and working home and mobile phone. There are ample age-appropriate toys that appear to be safe and in good condition. There are no pools, hot tubs or any other bodies of water present during today's inspection. All hazardous materials and toxins are kept out of the reach of children, and it was observed that there are no toxins or hazardous items accessible today. The Off Limit Area are the Master Bedroom with master bathroom, the Applicants Daughter Room, Front and Backyard, and the garage. LPA discussed to the applicant that the Off Limit Areas will be inaccessible to children by locked doors, safety gates and visual supervision. The applicant owns the home and LPA reviewed the Applicants Mortgage Account Statement dated 08/10.2023.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2023

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PATEL, VIMU	FACILITY NUMBER: 435700386
	VISIT DATE: 09/08/2023

NARRATIVE

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The applicant completed the Health and Safety training completed on 04/15/2023, and CPR (Pediatric) and First Aid completed in 4/16/2023 with validity period of 2 years. The applicants completed the AB1207 Child Care Providers training online on 08/13/2023 at https://mandatedreporterca.com/. LPA reminded the applicant that AB1207 requires 2-year renewal. The applicant has records of Measles and Pertussis immunization, Influenza declination statement and TB clearance. LPA reminded the applicant that only the Influenza vaccination can be decline with a written declination.

LPA provided technical assistance during inspection with the following.

1. Review of all required forms and information to be kept on file (Children’s forms/Records, Facility forms/Records, Information to be posted) 2. Reporting and Notifications Requirements 3. General Information (Child Care Updates, Provider Information Notification, etc.) 4. Miscellaneous Resources (Resources and Referral Agencies, Child Care Law Center, etc.) 5. Family Child Care Home Licensing Laws and Regulations.

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 safe sleep regulations with the 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 the applicant 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.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2023

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: PATEL, VIMU	FACILITY NUMBER: 435700386
	VISIT DATE: 09/08/2023

NARRATIVE

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Resources for Providers https://cdss.ca.gov/inforesources/child-care-licensing/resources-for-providers

Watch these brief, informative videos to learn more about putting Licensing regulations and requirements into practice - https://ccld.childcarevideos.org/family-child-care-providers/

Applicant 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.

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 platform.

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.

The home is recommended for a FCCH Small license effective Friday, September 8, 2023.

Exit interview conducted and report was reviewed with the applicant, Vimu Patel.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2023

LIC809 (FAS) - (06/04)

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