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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621670
Report Date: 05/12/2023
Date Signed: 05/12/2023 02:49:58 PM

Document Has Been Signed on 05/12/2023 02:49 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:KAUR, PARMJITFACILITY NUMBER:
393621670
ADMINISTRATOR:KAUR, PARMJITFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 914-2980
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
05/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Parmjit Kaur TIME COMPLETED:
03:11 PM
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On May 12, 2023, Licensing Program Analyst (LPA) Stacey Williams conducted an unannounced 1 Year required inspection and met with Licensee, Parmjit Kaur. There were (14) fourteen children present in the home during the inspection. Licensee’s Assistant was also present in the home. Criminal record clearances have been verified. Facility fees were reviewed with Licensee. Licensee stated there are no new residents in the home since licensure. Licensee operation hours are Monday- Saturday 7:30AM- 7:30PM and does not provide overnight care.

LPA and Licensee toured the facility during the inspection. Off limit areas are the entire upstairs of the home, the dog run in the backyard and the garage. The backyard is fenced. There are no bodies of water on the property of the home. Licensee stated that there are no weapons in the home. Licensee has a dog in the home that she stated does not interact with the children in care. The dog remains in the off limit areas during childcare hours.

LPA conducted record reviews during the inspection. A selection of child files, Licensee and her Assistant’s file was reviewed. LPA discussed mandated reporter training with the Licensee. Licensee and her Assitant has current Mandated Reporter Training on file. Licensee understands Mandated Reporter Training is to be completed every two years. Mandated reporter training can be accessed at www.mandatedreporterca.com. CPR/First Aid certification was reviewed for Licensee and her Assistant. Upon file review, there was no record of infants individual sleep plan on file. Sleep logs were not current in infants files. LPA observed fire drills were conducted at least once every six months and documented.

LPA observed that there were no hazardous items accessible to children. LPA observed that cleaning materials were inaccessible. Fire extinguisher, smoke detector, and carbon monoxide detector meet regulation standards. Toys appear to be safe.

REPORT CONTINUED ON SUBSEQUENT PAGE, 809 C
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2023
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: KAUR, PARMJIT
FACILITY NUMBER: 393621670
VISIT DATE: 05/12/2023
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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 of the 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.

This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. The following information regarding ADA Information 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 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.


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 [email protected]. 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/process.

Title 22 Deficiencies were observed and will be cited on subsequent page, LIC 809D.

LPA reviewed report with the Licensee, Parmjit Kaur and provided copies along with Appeal Rights. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/12/2023 02:49 PM - It Cannot Be Edited


Created By: Stacey Williams On 05/12/2023 at 02:23 PM
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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: KAUR, PARMJIT
FACILITY NUMBER: 393621670

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 4 out of 4 infant files which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/31/2023
Plan of Correction
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Licensee will ensure that all infants under the age of 24 months have current sleep logs in their file. Sleep logs are to be documented daily every 15 mins while the infant is sleeping. Licensee will provide LPA copies of current sleep logs for all infants in care by POC date- 6/12/23. Licensee shall ensure that all infants in care have a documented sleep log on file .
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 2 out of 2 infant files which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/31/2023
Plan of Correction
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Licensee will review the LIC 9227 with the infant's authorized representative and have the completed form in file. Copies of the completed form will be sent to LPA by POC date. Licensee will provide a statement indicating that she will include the review of the LIC 9227 for all newly enrolled infants with their authorized representatives.
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: 05/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2023


LIC809 (FAS) - (06/04)
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