013422736-6-27-2019-52-CC-JPLA-BDJRK3-20190627130453

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422736
Report Date: 06/27/2019
Date Signed: 06/27/2019 01:05:03 PM

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:	LAKSHMANAN, LAKSHMI PRABHA		FACILITY NUMBER:	013422736
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	06/27/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Lakshmi Prabha Lakshmanan		TIME COMPLETED:	01:20 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	Licensing Program Analyst (LPA) Julia Placencia arrived unannounced at 11:30am for an Annual/Random Inspection, and also to determine if the licensee is ready for an INCREASE IN CAPACITY. LPA met with Licensee Lakshmi Prabha Lakshmanan. Also residing in the home is the licensee's fingerprint cleared spouse, and 10 and 12 year old sons. Present were one school age and five preschool age children. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 7:00am to 6:00pm. The home is a single story, and consists of a kitchen/nook, dining room, living room, day care room, three bedrooms, two bathrooms, garage and a backyard. The home is neat and clean, with heating and ventilation for safety and comfort. ON LIMITS: Kitchen/nook, dining room, living room, day care room, first bedroom on the right in hallway, hallway bathroom, backyard. OFF LIMITS: Master bedroom/bathroom at end of hallway, bedroom on the left in hallway, garage, left side yard and storage shed. Off limit areas are inaccessible by closed and/or locked doors and visual supervision. Licensee is aware she must contact Licensing, so that an inspection can be completed prior to changing an off limits area to on limits. Per the fire clearance, day care activities are not permitted in garage. The large outdoor play area is fenced, is free from defects and dangerous conditions and has a tennis court. There is a locked shed and locked hot tub in the off limit area of backyard, which also has a 3 foot high fence separating the area from the tennis court. There were ample age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. There is a fully charged 2A10BC fire extinguisher, working carbon monoxide and smoke detectors, and telephone, There is a wood burning stove that is gated. Per licensee, there are no firearms in the home.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

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: LAKSHMANAN, LAKSHMI PRABHA	FACILITY NUMBER: 013422736
	VISIT DATE: 06/27/2019

NARRATIVE

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All required licensing documents are posted and visible for public review. Children's files were reviewed and found to be complete. The facility roster was reviewed, and a copy obtained. The licensee is in ratio today. The licensees' Pediatric CPR and First Aid certificate is current and expires 3/2020. The licensee has proof off the required immunizations, and mandated reporter training was completed 3/24/19. Safe sleep practices were discussed with licensee, and new car seat laws were provided. Licensee was reminded that children are never to be left in a parked vehicle.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, 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 encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

There were no deficiencies observed during today's inspection. This report shall remain on file for 3 years. A Notice of Site visit was posted at time of inspection and must remain posted for 30 days.

The department received the approved fire clearance from the City of Fremont on 6/10/19. Licensee has met all requirements for the Increase of Capacity. As of today's date, 6/27/19, licensee may begin operating as a Large Family Day Care.

Exit interview conducted with Lakshmi Prabha Lakshmanan. Copy of report and appeal rights provided.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

LIC809 (FAS) - (06/04)

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