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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420166
Report Date: 01/18/2024
Date Signed: 01/18/2024 03:56:44 PM

Document Has Been Signed on 01/18/2024 03:56 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:RAVANI, MAUSAMIFACILITY NUMBER:
013420166
ADMINISTRATOR:RAVANI, MAUSAMIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 978-3000
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
01/18/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Licensee, Mausami RavaniTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee Mausami Ravani for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Present during this inspection was the Licensee, supervising two (2) preschoolers. The home is a two-story home with four bedrooms, two bathrooms, and a loft on the second floor. The first floor consists of a living room, family room, kitchen, dining area, laundry room, garage, bedroom, bathroom, and back yard. The Licensee lives in the house with her husband and daughter. The provider operates a part-time program, 9:00 am- 12:30 pm, Monday -Friday. The facility has liability insurance through DCI Insurance.
ON-LIMIT AREAS: living room, family room, kitchen, dining area, downstairs bathroom, and backyard.
OFF-LIMIT AREAS are the entire second floor, downstairs bedroom, laundry room, and garage. All the off limit areas are made inaccessible to children by locked doors, safety gates, and visual supervision.
LPA observed the following: The Daycare Area is clean, orderly, and equipped with age-appropriate toys and equipment for children, indoors and outdoors. The home has a working telephone, a working smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. There are no bodies of water in the facility. The Fireplace in the Daycare area is screened to prevent access, and the provider stated that she does not use the Fireplace during operational hours. There are child size tables and chairs for snacks and activities. The outdoor play area is fenced. The Licensee states there are no guns or weapons of any kind in the home. Electrical outlets have child protective covers in place, making them inaccessible to children. The provider is reminded that NO walkers, exersaucers, jumpers, bouncers, or similar items are to be used for children in care and shall be made inaccessible. A child safety gate at the bottom of the stairs prevents access to the stairs and upper levels for children in care. The Licensee's CPR expires on 08/25, and Mandated reporter training expires on 01/22/2024. The Licensee conducted the last emergency drill on 08/23, which is properly logged. The Licensee provides daily snacks. Discipline policy is redirection. LPA reviewed children's files. All the files are complete and up to date. All required postings are properly posted. A copy of the children's roster was available for review, and a copy was obtained. The Licensee was reminded about the infant's sleep checks; however, the facility has no infants enrolled.
See the next page.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: RAVANI, MAUSAMI
FACILITY NUMBER: 013420166
VISIT DATE: 01/18/2024
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During Inspection, Licensee 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.

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 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.



Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

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/inspection-process.

No deficiency is cite today.

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

Exit interview conducted and report was reviewed with the licensee, Mausami Ravani

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024
LIC809 (FAS) - (06/04)
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