013422617-6-22-2023-52-CC-AWRT-CT2VEJ-20230622162226

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422617
Report Date: 06/22/2023
Date Signed: 06/22/2023 04:22:31 PM

Document Has Been Signed on 06/22/2023 04:22 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:	JOSEPH SELVARAJ, RAJEE		FACILITY NUMBER:	013422617
ADMINISTRATOR:	JOSEPH SELVARAJ, RAJEE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 216-8887
CITY:	FREMONT	STATE: CA	ZIP CODE:	94555
CAPACITY:	14	CENSUS: 7	DATE:	06/22/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Rajee Joseph Selvaraj		TIME COMPLETED:	04:25 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 22nd, 2023@ 2:25pm, Licensing Program Analyst (LPA) April Wright met with licensee Rajee Joseph Selvaraj for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the home by the licensee. Present during the inspection were seven (7) preschool age children and the fingerprint cleared assistant Haritha Thoodi. LPA toured the home to conduct a health and safety inspection. Hours of operation are 8:30am - 6:00pm Monday through Friday. The two story home consists of two bedrooms, three bathrooms, converted garage, kitchen, laundry room, storage closet 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 couch in day-care room or the converted garage with assistant which is away from other children in care. Converted Garage is cleared by fire inspector and is used when weather restricts outside play, activities and diaper changing if required. Licensee has a dog which is kept in off limits areas during daycare hours. Parents are aware of a pet in the home. On limit areas include: Living room (Day-care area), downstairs bathroom, converted garage and backyard. The backyard has a large and small play structures with slides that have grass cushion to absorb falls. Off-limits areas include: Entire second level of home including all bedrooms and bathrooms, laundry room, storage closet and kitchen. Off limits areas are made inaccessible by child safety gates, closed and/or locked doors and visual supervision. There is a gate at the bottom of the stairs to prevent access to the second level of the home. There are no pools hot tubs or any other bodies of water present. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection. There are ample age appropriate toys that appear to be safe and in good condition. See LIC 809C for continuance..

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April Wright	TELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

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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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: JOSEPH SELVARAJ, RAJEE	FACILITY NUMBER: 013422617
	VISIT DATE: 06/22/2023

NARRATIVE

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The home has a two (2) fully charged 3A40BC fire extinguishers, three (3) working smoke and second (2) carbon monoxide detectors and telephone service. There is a fire place that is blocked and inaccessible to children in care. Per licensee there are no firearms in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers.

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

LPA requested and reviewed the files of seven (7) children in care. Files for licensee and assistant were also reviewed. 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 4/26/2023. CPR/First Aid expires on 9/24/2024 and Mandated Reporter training certificates were completed on 4/4/2022. 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, 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/.

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. See LIC809C for continuance..

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April Wright	TELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: JOSEPH SELVARAJ, RAJEE	FACILITY NUMBER: 013422617
	VISIT DATE: 06/22/2023

NARRATIVE

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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

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.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Rajee Joseph Selvaraj.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April Wright	TELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

LIC809 (FAS) - (06/04)

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