013423062-3-3-2022-52-CC-RHAR-CC6UPN-20220303144550

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423062
Report Date: 03/03/2022
Date Signed: 03/03/2022 02:45:59 PM

Document Has Been Signed on 03/03/2022 02:45 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:	AMBA BHAVANI LLC/DBA KEEN LEARNERS MONTESSORI		FACILITY NUMBER:	013423062
ADMINISTRATOR:	AMBERKER, KSHAMA N.		FACILITY TYPE:	840
ADDRESS:	38660 LEXINGTON ST.		TELEPHONE:	(510) 396-2403
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY:	30	CENSUS: 6	DATE:	03/03/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:04 PM
MET WITH:	Kshama Amberker		TIME COMPLETED:	02:50 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 March 3, 2022 at approximately 1:00pm, LPA Haderer began the unannounced annual inspection for compliance to Health and Safety. The new CARE tool was used for the inspection. Present for the inspection was the site director Kshama Amberker, 1 teacher and 6 children in care. The facility is in ratio today. The facility has two license numbers, pre-school is on the ground floor, school age is upstairs. For the school-age children on the second floor there is one large room divided into 3 area. There are separate boys and girls bathrooms and one additional bathroom. All children’s bathrooms have enough towels and soap supplies. Sinks do not use hot water, only cold water is available. The staff has a separate adult bathroom. The children have their own fenced outdoor playground area and playground equipment. There is a waiver issued that requires that children alternate their time in the playground to meet space requirements (square footage per child indoor/outdoor space). LPA observed that all playground structures and toys are in safe condition and free from sharp, loose or pointed parts. The areas around or under high climbing equipment and slides have appropriate cushioned material that absorbs a fall. There is ample shade provided by large trees. Children bring in bottled water and each classroom also has a water fountain and jugs of water with paper cups. All classroom had trash cans with tight fitting lids. First aid kits were available in each classroom and in the outside playground area. The facility has fully charged fire extinguishers in the building. There is a 3A40BC fire extinguisher in first floor hallway and upstairs there is a 4A80BC. The last annual inspection was done on both on 4/14/2021. Fremont Fire Department conducts fire inspections. Carbon monoxide and smoke detectors were available, tested and functioning. Heating and ventilation in the classroom is acceptable. Disaster drills are conducted monthly, the last drill was conducted 3-2-2022.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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: AMBA BHAVANI LLC/DBA KEEN LEARNERS MONTESSORI	FACILITY NUMBER: 013423062
	VISIT DATE: 03/03/2022

NARRATIVE

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The facility is clean and well organized with ample age appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. The school follows proper Covid-19 protocols, parents and visitors are not allowed, children and staff are all wearing face coverings. Hazardous items/toxins are kept out of the access of children. There are no bodies of water accessible to children in care. The facility provides snacks and lunch for the children, menus were appropriately posted in each classroom.

At 1:15pm staff files were reviewed. Opening and closing staff have current CPR and first aid training. All staff subjected to criminal review have been cleared and associated to the facility.

At 1:30pm, children's records were reviewed: LPA requested and reviewed facility roster, a copy was taken for the office file. All files were well organized and complete.

All documents required to be posted were appropriately posted on the walls: License; Emergency Disaster Plan; Earthquake Preparedness checklist; Notification of Parents Rights; Personal rights; Child seatbelt laws; menus; daily activity schedules.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Site Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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: AMBA BHAVANI LLC/DBA KEEN LEARNERS MONTESSORI	FACILITY NUMBER: 013423062
	VISIT DATE: 03/03/2022

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 26 27 28 29 30 31 32	There were no deficiencies issued this day. This report will remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Annual inspection for this license component was completed at 2:50 pm. Exit interview conducted and report was reviewed with the Site Director Kshama Amberker.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell Haderer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

LIC809 (FAS) - (06/04)

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