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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422346
Report Date: 06/30/2022
Date Signed: 06/30/2022 01:25:36 PM


Document Has Been Signed on 06/30/2022 01:25 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:GURRALA, SARASWATHI & KRISHNAFACILITY NUMBER:
013422346
ADMINISTRATOR:GURRALA, SARASWATHIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 489-8864
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:14CENSUS: 7DATE:
06/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:26 PM
MET WITH:Saraswathi & Krishna Gurrala- LicenseesTIME COMPLETED:
01:35 PM
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On 6/30/22 at 12:26pm, Licensing Program Analyst Briana Plumboy, met with licensees Saraswathi & Krishna Gurrala for an UNANNOUNCED REQUIRED 1 YEAR RANDOM INSPECTION. Present for this visit was 4 infants, 3 preschool age children, 2 teenagers (1 assistant and 1 of licensees daughters), and licensees fingerprint clear and associated mother Samrajyamma Gurrala. The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday through Friday from 7:00am until 7:00pm.

The home is a 2 story home. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the living room, bathroom, the daycare room in the back room of the home, and a portion of the backyard. The OFF LIMIT AREAS are the dining room, the kitchen, the garage, the laundry room, and the entire 2nd level of the home which will be inaccessible by closed and/or locked doors and visual supervision. There is a gate at the bottom of the stairs to prevent access to the 2nd story of the home. There is a gate barricading the on limit daycare rooms and daycare bathroom from the off limit dining room and kitchen. The ISOLATION AREA will be the living room. The BACKYARD play area is completely fenced. There are ample age appropriate toys that appear to be safe and in good condition. There are no pools, hot tubs or any other bodies of water. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible during today's inspection.

The licensees CPR and First Aid certificate is current and expires 3/19/24. Both licensee's received mandated reporter training certificates on 02/20/21. Both licensees have received the required provider immunization's. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted and documented on 04/11/22. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. There is a screened fireplace in the dining room and a wall heater which is screened to prevent access by children. Licensees are documenting safe sleep checks during nap time.

All REQUIRED forms are posted and visible for public review. See 809-C for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/30/2022
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: GURRALA, SARASWATHI & KRISHNA
FACILITY NUMBER: 013422346
VISIT DATE: 06/30/2022
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Incidental Medical Services (IMS) policy was discussed. 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

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensees Saraswathi & Krishna Gurrala 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 licensees Saraswathi & Krishna Gurrala 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.

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

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensees Saraswathi & Krishna Gurrala.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022
LIC809 (FAS) - (06/04)
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