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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408599
Report Date: 01/27/2023
Date Signed: 01/27/2023 09:37:50 AM


Document Has Been Signed on 01/27/2023 09:37 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:SOLARAJ GOPALA, RAMA DEVIFACILITY NUMBER:
073408599
ADMINISTRATOR:SOLARAJ GOPALA, RAMA DEVIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 217-1295
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY:14CENSUS: 5DATE:
01/27/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Rama Devi Solaraj GopalaTIME COMPLETED:
09:45 AM
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On January 27, 2023 at 8:45am, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced for a plan of correction (POC) inspection to confirm facility is within its ratio/capacity limits. LPA met with licensee Rama Devi Solaraj Gopala. Present were two infants, three preschoolers, and helpers Nithya Jayaraman and Venkata Parvathareddy.

At start of the facility's Required-1 Year inspection conducted on 1/20/23, LPA observed licensee with 11 children (4 infants and 7 preschoolers) and no helper present until approximately 15 minutes after LPA's arrival. Upon arrival today, LPA observed three children (one infant and two preschoolers) and helper Venkata Parvathareddy. LPA observed signed Acknowledgement of Receipt of Licensing Reports forms (LIC 9224) in children's files.

Section 102416.5(e) Staffing Ratio and Capacity cited on 1/20/23 is cleared today. Copy of Letter of Deficiency Citations Cleared provided at visit.

Exit interview conducted with licensee Rama Devi Solaraj Gopala and copy of report provided. A Notice of Site Visit was provided and must remain posted for 30 days.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:
DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/27/2023
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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