013422787-1-29-2024-52-CC-JJAN-CZXTQW-20240129135637

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422787
Report Date: 01/29/2024
Date Signed: 01/29/2024 01:56:52 PM

Document Has Been Signed on 01/29/2024 01:56 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	TRIVEDI, POOJA & ROHIT		FACILITY NUMBER:	013422787
ADMINISTRATOR:	TRIVEDI, POOJA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(313) 515-5514
CITY:	FREMONT	STATE: CA	ZIP CODE:	94538
CAPACITY:	14	CENSUS: 11	DATE:	01/29/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Pooja Trivedi		TIME COMPLETED:	02:05 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 01/29/2024 at 11:55AM, Licensing Program Analyst (LPA) Jaleesa Jackson arrived for an Unannounced Required Inspection, and met with Licensee Pooja Trivedi. Present for this inspection were Licensee Rohit Trivedi, 8 preschool aged children, 3 infants, and two fingerprint cleared staff members. Also residing in home are the Licensee's two minor children. Licensee stated that her in laws live in an in law unit on the property and both have fingerprint clearance. The home was toured with the Licensee to conduct a health and safety inspection. Hours of operation for daycare are Monday through Friday, 9:00AM to 5:00PM. ON LIMITS: childcare room (family room), outdoor bathroom, fenced backyard, shaded area in backyard (isolation area), and right side yard used for entry way to day care OFF LIMITS: garage, all four bedrooms, hallway bathroom, living room, kitchen, dining area, master bathroom, left side yard, outdoor shed, separate unit for "in laws", and front yard. Off limit areas are inaccessible by closed and/or locked doors, gates, child safety locks, and visual supervision. The home is single story, owned by the Licensees with heating and ventilation for safety and comfort. The entrance to the daycare is the gate on the right side of the house. There were ample age appropriate toys that were observed to be safe and in good condition. Licensee stated that children are utilizing cots for sleeping and are given to parents weekly to clean. During today's inspection all toxins, medicines, and hazardous items were inaccessible. There was a fully charged 2A10BC fire extinguisher, working carbon monoxide, smoke detector, and telephone at the premises. Licensee stated that there are no firearm, pets or smoking in the home. The licensee conducts and documents disaster drills. The last fire drill was conducted 1/22/24 and the last earthquake drill was conducted 1/2/24. All required licensing documents are posted and visible for public review. Continued 809-C

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa Jackson	TELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024

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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: TRIVEDI, POOJA & ROHIT	FACILITY NUMBER: 013422787
	VISIT DATE: 01/29/2024

NARRATIVE

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At 11:55AM, LPA toured the backyard area. LPA did not observe any pools, hot tubs, or similar bodies of water present. At 12:25AM, 5 children's files were reviewed and found to be complete. Licensees are conducting and logging sleep logs for infants in care. Licensees has daycare insurance from Markel Insurance Company on file from 03/23/2023 to 03/23/2024. The facility roster was reviewed and a copy obtained. The Licensees are in ratio today. Both Licensees have current CPR expiring 7/2025 and 9/2025. Both assistants have current CPR as well expiring 12/2025 and 9/2025.

There were no deficiencies were cited for today's inspection.

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 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 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.

Continued 809-C

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa Jackson	TELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024

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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: TRIVEDI, POOJA & ROHIT	FACILITY NUMBER: 013422787
	VISIT DATE: 01/29/2024

NARRATIVE

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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/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Pooja Trivedi, 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 the licensee Pooja Trivedi.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Jaleesa Jackson	TELEPHONE: (510) 368-0021
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024

LIC809 (FAS) - (06/04)

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