434416220-10-6-2022-07-CC-SCOS-CJY6JX-20221006205152

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416220
Report Date: 10/06/2022
Date Signed: 10/06/2022 08:51:57 PM

Document Has Been Signed on 10/06/2022 08:51 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CHOPPALA, DEEVENA		FACILITY NUMBER:	434416220
ADMINISTRATOR:	DEEVENA CHOPPALA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	4082168630
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95133
CAPACITY:	14	CENSUS: 10	DATE:	10/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:			TIME COMPLETED:	04:46 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Page 1 Licensing Program Analyst (LPA), Stephanie conducted Annual inspection of the day care home today and was greeted by Licensee, Deevena Choppala. LPA observed 10 children and (3) staff supervising the children. There are 4 adults residing in the home licensee’s husband ( Prabhakar Choppala and two sons (Lauren Choppala and Sam Choppala. Licensee Deevena Choppala 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. Review of records indicates that all individuals who require caregiver background checks have received criminal record clearance. Days and hours of operation are Monday thru Friday from 8:30AM to 5:30PM. LPA toured the home inside and out with the Licensee. Off limit areas inside the home: . garage and all bedrooms and living room area. The home was observed to be clean and in good order. There are sufficient toys and play equipment for the day care children. Bathroom used by children was observed to be clean and in good condition. Per Licensee, there are no weapons and poisons in the home. Cleaning Products, toxic agents, medications, and sharp objects are inaccessible to children. The home has a fire extinguisher (2A10BC ), carbon monoxide and smoke detectors. The outdoor playground area is surrounded and enclosed by a fence. There are no bodies of water observed.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CHOPPALA, DEEVENA	FACILITY NUMBER: 434416220
	VISIT DATE: 10/06/2022

NARRATIVE

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Staff records were reviewed which include fingerprint clearance, TB clearance, immunization (Measles, Pertussis, and Flu) record, and current CPR/First Aid and Mandated Reported Training Certifications. LPA discussed with Licensee Assembly Bill (AB) 1207 (Mandated Child Abuse Reporting Training) which is a required training every two years.

LPA obtained an updated copy of the roster of children in care. a percentage of Children's records were reviewed which include Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice and Immunization record. and fire/disaster drills must be practiced at least once every 6 months and documented. LPA also reminded the Licensee that smoking, baby walkers, and similar items are not allowed in Family Child Care Homes.

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA

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 [facility representative] 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.

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

Exit interview conducted and report was reviewed with the licensee Deevena Choppala

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022

LIC809 (FAS) - (06/04)

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