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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418570
Report Date: 06/13/2024
Date Signed: 06/13/2024 04:36:54 PM


Document Has Been Signed on 06/13/2024 04:36 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:KAPOOR, RASHIFACILITY NUMBER:
013418570
ADMINISTRATOR:KAPOOR, RASHIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 797-2640
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY:14CENSUS: 3DATE:
06/13/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Tarunika KapoorTIME COMPLETED:
04:35 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 June 13th, 2024 at approximately 2:25pm, Licensing Program Analyst (LPA) April Wright arrived for an Annual/Random Inspection and met with Licensee daughter Tarunika Kapoor. Licensee Rashi Kapoor was currently at medical appointment at the time of the inspection. Present for this inspection were three (3) infant age children and the licensee's fingerprint cleared assistant Shashi Joshi. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation are Monday through Friday, 9:00am to 5:30pm.
The two story home consists three (3) bedrooms, two and one half (2 1/2) bathrooms, living room, family room area, kitchen, dining area, laundry closet, backyard and garage. The home was neat and orderly, with heating and ventilation for safety and comfort of children in care. There is a child safety gate in place and is secured at the bottom of the stairs to prevent access to the second level of the home. The isolation area is a section of the living room which is away from children in care.

ON LIMITS: Living room (day-care area #2 and isolation area), family room (main daycare room), first floor bathroom (to the right of staircase) and backyard.


OFF LIMITS: First Floor: Garage and Laundry closet. Entire second level of the home which includes, all three (3) bedrooms including master bedroom, upstairs bathroom and master bathroom. Off limit areas are inaccessible by closed and/or locked doors and visual supervision.

The backyard is completely fenced and is free from defects, damage and hazardous conditions. There are age appropriate toys that LPA observed to be safe and in good condition. LPA observed and Licensee confirmed that are no toxins, medicines, cleaning products or hazardous materials visible during today's inspection and were made inaccessible to children in care. There is a fully charged 3A40BC fire extinguisher, working carbon monoxide/smoke detectors, working telephone and first aid kit. The fireplace has a glass cover and is blocked by a toy shelf which makes it inaccessible to children in care. Per licensee daughter, there are no firearms or weapons in the home. LPA observed and Licensee daughter confirmed that there are no pools, hot tuns or any bodies of water present in the home. See LIC809C for continuance..
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2024
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 3


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: KAPOOR, RASHI
FACILITY NUMBER: 013418570
VISIT DATE: 06/13/2024
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
All individuals subject to criminal record review have a clearance or exemption and have been associated to the this FCCH. LPA requested and reviewed the files of three (3) children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The children's roster was reviewed and copies were obtained. The licensee conducts fire and disaster drills twice a year and the last was conducted on 4/8/2024. The licensee and assistant has current Mandated reporter training which was completed on 2/8/2024 and CPR/First aid certificate which expires for the licensee on 6/2025 and their assistant on 2/11/2026. The licensee is in ratio today. All required forms are posted and visible for public review upon entry to the home.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days 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 athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP . 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: https://www.ada.gov/resources/child-care-centers/.

See LIC809C for continuance.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: KAPOOR, RASHI
FACILITY NUMBER: 013418570
VISIT DATE: 06/13/2024
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
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, Licensee daughter Tarunika, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Licensee daughter Tarunika Kapoor assisted in today's inspection due to language barrier/understanding with Licensee assistant Sashi Joshi.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee daughter Tarunika Kapoor.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3