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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700331
Report Date: 10/19/2023
Date Signed: 10/19/2023 10:39:33 AM

Document Has Been Signed on 10/19/2023 10:39 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:YOGASUNDRAM, SAJINIFACILITY NUMBER:
435700331
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
10/19/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Sajini YogasundramTIME COMPLETED:
11:00 AM
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On 10/19/2023 at 10:00am, Licensing Program Analyst (LPA) Christina Uribe conducted an unannounced Case Management visit and met with licensee, Sajini Yogasundram. Also present during today's inspection is the licensee's fingerprint cleared husband, Nalin Yogasundram, and licensee's fingerprint cleared assistant Yiting "Judy" Wang and 6 day care children. The purpose of today's visit is to change the on-limit areas of the home for day care use.

The new on-limit areas are the detached unit in the backyard which consists of two stories, one large room and half bathroom on the first floor and two small rooms and a full bathroom on the second story. The second story also has a full kitchen. The backyard is still on-limits to children in care.

Licensee has submitted a new Facility Sketch (LIC 999A) to LPA Uribe and all on-limit/off-limit rooms are clearly labeled. There is a fully functional carbon monoxide detector, smoke detector, and a full charged 2A10BC fire extinguisher in the on-limit areas. The entire main house will be off-limits to children in care.

LPA Uribe has inspected the physical plant of the new on-limit areas. All hazardous materials are properly stored and kept out of reach to prevent access to children in care. The change is on-limit/off-limit areas are being approved for day care use effective today, 10/19/2023.

Licensee also discussed plans to submit a capacity increase application with LPA Uribe.

Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements will result in the immediate civil penalty of $100. Exit interview was conducted and report was reviewed with the licensee, Sajini Yogasundram.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2023
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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