<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700368
Report Date: 07/28/2023
Date Signed: 08/03/2023 12:26:25 PM

Document Has Been Signed on 08/03/2023 12:26 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KAMATH, JAYALAKSHMIFACILITY NUMBER:
015700368
ADMINISTRATOR:KAMATH, JAYALAKSHMIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 891-5619
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
07/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Helpers Ayashmita Das and Chaitali SahaTIME COMPLETED:
02:40 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
Licensing Program Analyst (LPA) Jyoti Saini met with helpers, Ayashmita Das and Chaitali Saha for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the helper. Licensee is on the vacation. Present during this inspection was two helpers, supervising two infants, three preschoolers. Licensee lives in the house with her husband and two minor children. The home is a two story home with 4 bedrooms, 3 bathrooms, a living room, sunroom, dining room, kitchen, family room, 2 car garage, and backyard. The hours of operation are 8:30am to 6:00pm Monday -Friday.

Day care area living room, sunroom (main day care), the family room which will used as the nap room, kitchen, dining room, and first floor’s master bedroom and bathroom that is located to the right of the entrance.

Off-limit-areas: entire second floor and garage, and made inaccessible to children by locked doors, safety gates and visual supervision.

LPA inspected the house for health and safety hazards. Daycare Area is clean, orderly, and equipped with age-appropriate toys and equipment for children, indoors and outdoors. Home has a working telephone, a working smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. There are no bodies of water in the daycare. The home has an electric fireplace which is located inside the living room and is screened to prevent access to children. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 05/10/2023. There are child size tables and chairs for snack and activities. The napping room had cots in good condition and each child have their separate blankets. The helper states there are no guns or weapons of any kind in the home. There are no pets in the home. There is a child safety gate located at the bottom of the stairs to prevent access to the stairs and upper levels to children in care. The outdoor play area is fully fenced. The helpers have valid CPR. Licensee provides daily snacks and meals. Discipline policy is redirection. LPA reviewed children’s files. All the files are complete and up to date. All required postings are properly posted. LPA advised documenting 15 minutes sleep check.

see next page..

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/28/2023
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KAMATH, JAYALAKSHMI
FACILITY NUMBER: 015700368
VISIT DATE: 07/28/2023
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
26
27
28
29
30
31
32
During Inspection, 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 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.



Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

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/inspection-process.

No deficiency is cited today however, two technical violations were given.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the helpers, Chaitali Saha and Ayashmita Das..

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4