Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618986
Report Date: 09/13/2017
Date Signed 09/13/2017 12:09:03 PM

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:POONI, RUMINDERJIT & BALWINDERFACILITY NUMBER:
343618986
ADMINISTRATOR:POONI, BALWINDERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 419-4306
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:14CENSUS: 5DATE:
09/13/2017
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Pooni, Ruminderjit & BalwinderTIME COMPLETED:
12:15 PM
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Licensing Program Analysts (LPAs) Kristal Goodell and Seychelle De Luca met with licensees, Ruminderjit and Balwinder Pooni, for the purpose of an unannounced required - 3 year random inspection. Hours of operation are 6:30AM- 6:00PM, Monday through Friday. Also present in the home was Parkash Kaur. All individuals subject to criminal background review have obtained a criminal record clearance.

A health and safety inspection was conducted in all areas accessible to children. Adequate supervision was observed. Off-limits areas include the entire upstairs, shed in the backyard, gardens in the backyard, laundry room, and garage. LPAs observed a working phone, fire extinguisher, and functioning smoke and carbon monoxide detectors. Licensees stated there are no weapons in the home. No children were observed in parked cars. Toxic and hazardous items are inaccessible to children. Safe toys and comfortable accommodations were observed. The fireplace in the home was appropriately barricaded to prevent access by children. Outdoor play space is fenced.

Children's records were reviewed. Emergency information and required immunization records were on file. Preventative health training, current pediatric CPR and first aid certification was verified and expires 01/31/19.

Report continues on LIC-809C
SUPERVISOR'S NAME: Monica R FiliceTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Kristal GoodellTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2017
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: POONI, RUMINDERJIT & BALWINDER
FACILITY NUMBER: 343618986
VISIT DATE: 09/13/2017
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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.

This facility evaluation report was reviewed and discussed with the licensee. A notice of site visit was provided and should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at WWW.CDSS.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request. The licensee's signature on this form acknowledges receipt of this form.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.
SUPERVISOR'S NAME: Monica R FiliceTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Kristal GoodellTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2017
LIC809 (FAS) - (06/04)
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