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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416284
Report Date: 03/24/2022
Date Signed: 03/25/2022 08:19:42 AM


Document Has Been Signed on 03/25/2022 08:19 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:VIDYARAMBHFACILITY NUMBER:
434416284
ADMINISTRATOR:SUJATHA NAMBOODIRIFACILITY TYPE:
830
ADDRESS:20015 STEVENS CREEK BOULEVARDTELEPHONE:
(408) 444-5019
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY:12CENSUS: 5DATE:
03/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Sulakshana ShravageTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Marilou Monico met with Site Director, Sulakshana Shravage, Site Director, for an unannounced Required 1-year inspection. Facility's License, Notification of Parents’ Right Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, and Earthquake Preparedness Checklist were observed to be posted. The program has an active waiver: to allow licensure for 12 children even though the outdoor space is measured for 8 children. The center's operating hours are Monday through Friday 08:45 AM to 6:00 PM. The facility serves children ages 12 months to 24 months.

LPA toured the facility both indoor and outdoor. LPA observed that the facility was operating in compliance with teacher to children ratio requirement. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. Floors were clean.

Foods and beverages were kept protected against contamination and spoilage. Drinking water is available for the children indoor via sippy cups. Trash can for solid waste had tight-fitting cover on, and is in good repair. Fire extinguisher, working smoke and carbon monoxide detectors were observed. LPA observed that each infant has current feeding, diaper, and nap log. The center has documentation that sleeping infants were checked every 15 minutes. Diapers are being disposed appropriately. The Infant Needs and Services Plan are updated quarterly. Each infant has personal items individually stored. LPA observed that few bottles and sippy cups were not labeled with the children's names.

Sulakshana stated that there are no firearms in the facility. Drinking water is readily available for the children outdoor via sippy cups. The whole outdoor space is covered with patio. The playground area is surrounded by appropriate fencing and the outdoor surfaces are safe. There were no bodies of water observed.

Continuation on next pages:
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
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 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: VIDYARAMBH
FACILITY NUMBER: 434416284
VISIT DATE: 03/24/2022
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LPA reviewed five (5) children's files. Children records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Medical Assessment, and Immunization.

Two (2) staff files were reviewed. Staff records reviewed include Criminal Record and Child Abuse Index Clearance, Employee Rights, Personnel Record, Education Verification, Health Screening Report with TB Clearance, Immunization (Measles, Pertussis, and Flu) record and required Training. LPA reminded Site Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. At least one staff member present during the inspection has current certification in Pediatric CPR and First Aid.

This facility provides Incidental Medical Services – IMS. Sulakshana stated that currently, there are no children using medication. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA 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

LPA discussed the safe sleep regulations with Site Director and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

Site Director was reminded that all adults 18 and over, 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 Child Care Center. 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.

Continuation on next page:
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: VIDYARAMBH
FACILITY NUMBER: 434416284
VISIT DATE: 03/24/2022
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

As a result of this inspection, deficiency was cited on the following page:

Exit interview conducted and report was reviewed with the Site Director, Sulakshana Shravage.

A Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 03/29/2022 12:40 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 03/29/2022 08:09 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131


FACILITY NAME: VIDYARAMBH
FACILITY NUMBER: 434416284

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101427(j)
Infant Care Food Service
(j) Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observation, few bottles and sippy cups were not labeled with the children's names.
POC Due Date: 03/25/2022
Plan of Correction
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Staff labeled the bottles and sippy cups during the inspection. Deficiency corrected.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4