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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423478
Report Date: 02/14/2024
Date Signed: 02/14/2024 02:45:53 PM


Document Has Been Signed on 02/14/2024 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:GUPTA, POOJAFACILITY NUMBER:
013423478
ADMINISTRATOR:GUPTA, POOJAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 242-4686
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:14CENSUS: 10DATE:
02/14/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:03 PM
MET WITH:Licensee , Pooja Gupta TIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee Pooja Gupta for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Present during this inspection was the Licensee and her husband supervising three (3) infant and seven (7) preschoolers. The Licensee lives in the house with her husband and two minor children. The two-story home has four bedrooms, 4.5 bathrooms, a living room, kitchen, dining room, laundry room, loft, garage, back yard, and an in-law suite. The hours of operation are 8:00 am to 5:30 pm Monday -Friday.
On-limits: The in-law suite( main daycare area), consists of two bedrooms and a bathroom. Half of the backyard is converted into play area. The outdoor play area has a separate entrance by the left side of the main door entrance( patio)
Off -limit areas: the second floor, 1st floor half bathroom, located near the stairs, the garage and half backyard. All off-limit areas are inaccessible by closed and locked doors and visual supervision.
LPA inspected the house for health and safety hazards.The daycare Area is equipped with age-appropriate toys indoors and outdoors. The home has a working telephone, a working smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. There are no bodies of water in the daycare area. There is a fireplace in the living room which is not in use. The Licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 12/21/2023. There are child-size tables and chairs for snacks and activities. The napping room had cots in good condition and each child have their separate blankets. The Licensee states there are no guns or weapons of any kind in the home. There are no pets in the house. Licensee documents 15 minutes sleep check.
The Licensee has valid CPR, which expires on 1/2026. Licensee and her husband have current Mandated Reporter Training on the file. The Licensee provides daily snacks and meals. Discipline policy is redirection. LPA reviewed children's files. All the files are complete and up to date. All required postings are properly posted.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


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: GUPTA, POOJA
FACILITY NUMBER: 013423478
VISIT DATE: 02/14/2024
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During Inspection, Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

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-and-resources/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.



Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

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

No deficiency is cited today however one (1) technical violation is given.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Pooja Gupta.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024
LIC809 (FAS) - (06/04)
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