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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421956
Report Date: 06/23/2023
Date Signed: 06/23/2023 12:24:03 PM


Document Has Been Signed on 06/23/2023 12:24 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:PATEL, VASUDHAFACILITY NUMBER:
013421956
ADMINISTRATOR:PATEL, VASUDHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 585-6666
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY:14CENSUS: 9DATE:
06/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Vashuda :PatelTIME COMPLETED:
12:20 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 23rd, 2023 at 9:35 am, Licensing Program Analyst (LPA) April Wright met with licensee Vasudha Patel for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the home by the licensee. There were nine (9) preschool children and fingerprint cleared assistant Deja Linarez. LPA toured the home to conduct a health and safety inspection. The Licensee is in ratio today. Hours of operation are 8:00am - 5:30pm Monday through Friday.

The two story home consists of five (5) bedrooms including master bedroom, four (4) bathrooms, kitchen, garage, office, living room, family room and backyard. The home was neat and orderly with heating and ventilation for safety and comfort of children in care. The isolation area is the home office which is a section away from other children in care.

On limit areas include: Day care room (Bedroom #3) and backyard.
Off-limits areas include: Entire second level. Bedroom #1& #2 on first floor, kitchen, family room and garage.

The off limits area and will be made inaccessible by closed/locked doors and visual supervision. There is a gate at the bottom of the stairs to prevent access to the upper level of the home. There are no pools, hot tubs or any other bodies of water present in the on limit areas. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection. There are age appropriate toys that appear to be safe and in good condition.

CAPACITY: The facility operates as a Family Child Care Home (large), which may have a maximum capacity of twelve (12) to fourteen (14) children. The Licensee is in ratio and capacity requirements.

See LIC809-C for continuance.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:
DATE: 06/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/23/2023
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 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: PATEL, VASUDHA
FACILITY NUMBER: 013421956
VISIT DATE: 06/23/2023
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
The home has a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, fully stock First Aid Kit. and telephone. There is a fireplace in the living room which is an off limits area, that is blocked and inaccessible to children in care. Per licensee there are no weapons or firearms in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers.

LPA requested and reviewed the files of nine (9) children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The facility roster was review and copies were obtained. The licensee conducts fire and disaster drills twice a year and the last was conducted on 2/17/2023. The licensee has a current CPR/First aid certificate which expires on 6/2025 and Mandated Reporter training completed on 8/26/2021. All required forms are posted and visible for public review.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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

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

DATE: 06/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023
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: PATEL, VASUDHA
FACILITY NUMBER: 013421956
VISIT DATE: 06/23/2023
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
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-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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. 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.

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

DATE: 06/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3