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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421942
Report Date: 06/13/2024
Date Signed: 06/13/2024 10:54:07 AM

Document Has Been Signed on 06/13/2024 10:54 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:SENTHILKUMAR, KADIRIMALLIKADEVIFACILITY NUMBER:
013421942
ADMINISTRATOR/
DIRECTOR:		SENTHILKUMAR,KADIRIMALLIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 796-6809
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
06/13/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Licensee, Kadirimallika SenthilKumarTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee Kadirimallikadevi Senthilkumar 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 Licensee, and her Mother supervising two infants. The Licensee lives in the house with her husband, daughter, and Mother. The home is two-story with four bedrooms, three bathrooms, a great room, a kitchen, a dining room, a laundry room, a loft, a garage, and a back yard. The hours of operation are 8:30 am to 6:00 pm, Monday -Thursday, and on Fridays, 8:30 am to 5:00 pm.
Day care area: kitchen, dining room, great room, downstairs bedroom to the right of the entrance, adjacent bathroom, and backyard.Off-limit-areas: the entire second floor and garage. All off limit areas are inaccessible by closed and/or locked doors and visual supervision.

LPA inspected the house for health and safety hazards. The home has a working telephone, a smoke and carbon monoxide detector, and a fire extinguisher meeting the minimum requirements. LPA did not observe any bodies of water or fireplace during today's inspection. The licensee states there are no guns or weapons of any kind in the home. There are no pets in the home. A child safety gate is located at the bottom of the stairs to prevent access to the stairs and upper levels for children in care. The outdoor play area is fenced. Licensee's CPR and first aid expires on 4/2026, and mandated reporter training expires on 4/2025. Children are required to bring their lunch and snacks. Discipline policy is redirection. The licensee conducts and documents fire/disaster drills at least twice a year, and the log indicates that a drill was conducted on 04/2024. LPA reviewed children's files. Both the infant files have LIC9227. All the files are complete and up to date. All required postings are properly posted. LPA discussed safe sleep guidelines and advised the licensee to document 15-minute sleep checks on a daily basis for infants up to the age of 2.


see next page.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2024
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: SENTHILKUMAR, KADIRIMALLIKADEVI
FACILITY NUMBER: 013421942
VISIT DATE: 06/13/2024
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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.

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

There are no deficiencies cited today however, one technical violation was given.

Exit interview conducted and report was reviewed with the licensee, Kadirimallikadevi Senthilkumar

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

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
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