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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700131
Report Date: 02/25/2022
Date Signed: 02/25/2022 10:31:20 AM


Document Has Been Signed on 02/25/2022 10:31 AM - 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:JOSHI, NIDHIFACILITY NUMBER:
015700131
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
02/25/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Nidhi JoshiTIME COMPLETED:
10:45 AM
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On 2/25/2022 Licensing Program Analysts (LPAs) Jaylena Miller and Kelly Phan met with licensee Nidhi Joshi for an announced CASE MANAGEMENT inspection for an INCREASE OF CAPACITY to a large family childcare home. Present for the inspection were licensees fingerprint cleared husband, two intermediate family members, assistant and 4 daycare children were present for the inspection.

The fire clearance for the increase of capacity was received and approved on 01/13/2022.

LPAs toured the on-limits area of the home and backyard for a health and safety inspection. The home has an acceptable amount of space, number of toys and furnishings that are neat, clean and age appropriate. The home is equipped with a 3A-40 BC fire extinguisher, working smoke detector, and working carbon monoxide detector. There is a working telephone in the home. Per licensee there are no firearms on the premises. There are no pools, hot tubs, or other bodies of water at the home. All poisons, cleaning solutions and medications are inaccessible to children. Licensee has current CPR and First Aid training which expires 08/07/2023, Mandated reporter training on 4/24/2020. LPA reminded licensee that CPR/First Aid and Mandatory Reporter training must be renewed every two years. Per the fire clearance inspection, the garage is off limits to children and the shed in the backyard, LPA Miller reminded licensee and confirmed the garage and shed would not be used as mentioned per the fire clearance. LPA also advised licensee that 100% visual and physical supervision is required when children are playing in the backyard.

This home is recommended for a large family home license as of 2/25/2022. There are no deficiencies cited. This report shall remain on file for 3 years. Exit interview conducted with Licensee and a copy of report provided and notice of site visit given and must be posted for 30 days.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jaylena MillerTELEPHONE: (510) 292-8297
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022
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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