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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406708
Report Date: 06/10/2021
Date Signed: 06/11/2021 11:22:03 AM

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:PANDEY, NAMITAFACILITY NUMBER:
073406708
ADMINISTRATOR:PANDEY, NAMITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 833-7967
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY:14CENSUS: 0DATE:
06/10/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Namita PandeyTIME COMPLETED:
12:10 PM
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On 6/10/2021 at 11:15am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Namita Pandey for an unannounced annual inspection. Present during the inspection was licensee Namita Pandey, her fingerprint cleared husband, Arvind Pandey and their 20-year-old son Achintya Pandey. There are no children present today. Licensee stated that she has been closed since March 2020 due to the pandemic. She plans to reopen August 2021. The Licensee’s home was toured for a health and safety inspection. When the Licensee opens in August, the operating hours will be 2:30pm – 6:30pm Monday – Friday. She will also be following the San Ramon Unified School District schedule.

ON LIMITS AREA: Children’s study room (parlor), living room, kitchen, downstairs bedroom, bathroom and


the back yard
OFF LIMITS AREA: Staircase, Garage, laundry room, and entire 2nd floor
ISOLATION AREA: Living Room

The facility is a two-story home owned by the Licensee. The inside of the home is observed to be neat, clean with ample age appropriate materials for the children that are safe and clean. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. Licensee has stated that there are no firearms or pets in the home.

The home has one (1) fully charged 3A40BC fire extinguisher, located in the garage. One (1) working carbon monoxide/smoke detector combination on the wall next to the laundry room and one working smoke detector on the ceiling in the living room. The home is equipped with central heating and air for proper ventilation. LPA observed no bodies of water in or around the home.

Cont on 809-C.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan PringleTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
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 3
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: PANDEY, NAMITA
FACILITY NUMBER: 073406708
VISIT DATE: 06/10/2021
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The Licensee’s Health and Safety training has been completed and CPR and First Aid training will be renewed. Licensee falls under the state waiver for expired CPR & First Aid trainings. All required forms are posted and visible for public review.

All the children that the Licensee had are no longer registered with her so there are no files to review. Since licensee has not had children in care for 15 months there is not a current fire drill log. The last drill was conducted on 1/2020.

Licensee was reminded that California Law requires licensees to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov. Licensee was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.



Incidental Medical Services (IMS) policy was discussed as well. Licensee was reminded that when any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information 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.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3,000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter.

Cont on 809-C
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan PringleTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: PANDEY, NAMITA
FACILITY NUMBER: 073406708
VISIT DATE: 06/10/2021
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Children’s Roster must be properly maintained, and fire/disaster drill must be conducted every six months and documented. The licensee is reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

This report was read and given to the Licensee for a signature. There are no deficiencies being cited today. This report shall remain on file for 3 years. Appel Rights were provided and exit interview conducted. A Notice of Site visit was posted at the time of inspection and must remain posted for 30 days.

SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan PringleTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
LIC809 (FAS) - (06/04)
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