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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415903
Report Date: 09/29/2021
Date Signed: 09/29/2021 02:32:59 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CHOUDARY, ARTHIFACILITY NUMBER:
434415903
ADMINISTRATOR:ARTHI CHOUDARYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 646-2373
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:14CENSUS: 10DATE:
09/29/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Arthi ChoudaryTIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Mel Matos met with Arthi Choudary, Licensee, for unannounced case management inspection. LPA was granted access to the home by the Licensee. LPA also observed ten day care children (4 infants, 4 preschool, Licensee's two children - ages 4 & 2 years), and one adult assistant (Richa Aggarwal) in the home during today's inspection. All children, except for one day care child, were napping during today's inspection.

LPA observed the COVID-19 postings near the entrance to the home. LPA also observed the Licensee, adult assistant, and one day care child (not napping) wearing face coverings during today's inspection.

LPA reminded the Licensee that all children two years and older and all adults must wear face coverings, except during eating and napping, per the guidance from the Santa Clara County Public Health Department and California Department of Public Health. The Licensee understands that she must adhere to the guidance issued by the public health department regarding face coverings at all times.

No deficiencies issued during today's inspection.


A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2021
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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