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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422797
Report Date: 01/21/2020
Date Signed: 01/21/2020 01:32:50 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:PATEL GANDHI, SANGITABENFACILITY NUMBER:
013422797
ADMINISTRATOR:PATEL GANDHI, SANGITABENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 305-4458
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:14CENSUS: 4DATE:
01/21/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Sangitaben Patel GandhiTIME COMPLETED:
02:00 PM
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On 0/21/20 at 1:07pm, Licensing Program Analysts Briana Plumboy and Manel Estoesta, met with licensee Sangitaben Patel Gandhi for an UNANNOUNCED RANDOM INSPECTION. The home was toured to conduct a Health and Safety Inspection. There were 4 infants in care today. The facility currently operates Monday- Friday from 7:00am until 6:00pm.

The home is two levels. The home consists of a family room, living room, kitchen, garage, 5 bedrooms, a laundry room, and 3.5 bathrooms. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the garage, downstairs master bedroom with bathroom, and the entire second level of the home which will be inaccessible by closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the family room, living room, kitchen, and downstairs bathroom. There is a gate located at the bottom of the stairs to prevent access to children under the age of 5 years old to the second level of the home. The ISOLATION AREA will be the living room. Outdoor play area will be the fenced backyard, and per licensee the children will not play on the left side of the home. There are no pools, hot tubs or any other bodies of water present in the on limit areas during today's inspection. All hazardous materials and toxins are kept out of the reach of children and it was observed that during the inspection there are no toxins or hazardous items accessible.

The home has a fully charged fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The licensee has CPR and First Aid with expiration date 07/24/21. The licensee received a certificate of completion in mandated reporting on 09/21/19. The licensee is in compliance with the immunization law. The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home.
There are no deficiencies cited during today's inspection. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020
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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