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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422617
Report Date: 09/30/2024
Date Signed: 09/30/2024 12:52:59 PM

Document Has Been Signed on 09/30/2024 12:52 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:JOSEPH SELVARAJ, RAJEEFACILITY NUMBER:
013422617
ADMINISTRATOR/
DIRECTOR:		JOSEPH SELVARAJ, RAJEEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 216-8887
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
09/30/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:25 AM
MET WITH:Rajee Selvaraj JosephTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
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On September 30, 2024, at approximately 11:25AM, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux met with licensee Rajee Joseph Selvaraj for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and granted entry into the home by the licensee LPA provided LIC 125. Present during the inspection were nine (9) children (4 infants and 5 preschool age) and fingerprint cleared assistant Neha Pradeep. LPA toured the home to conduct a health and safety inspection. Hours of operation: Monday - Friday 8:30am - 6:00pm.

This is a two story home consists of two (2) bedrooms, 2.5 bathrooms, converted garage, kitchen, laundry room, storage closet and backyard. The home was neat and orderly, with heating and ventilation for safety and comfort.

On limit areas include: Living room, main level half bathroom, converted garage and backyard. The outdoor play area is located in the backyard and is fully fenced and in good condition with no hazardous materials accessible to children in care. There is a shed that is locked during today's visit. There are no pools, hot tubs, or any other bodies of water present in the on-limit areas during today’s inspection. Licensee confirmed there are no pools/bodies of water during today's visit. There are ample age appropriate toys that appear to be safe and in good condition.

Off-limits areas include: Entire second level of home including all bedrooms and bathrooms, laundry room (main level), and kitchen. Off limits areas are made inaccessible by child safety gates, closed and/or locked doors and visual supervision. There is a gate at the bottom of the stairs to prevent access to the second level of the home.


LIC 809-C
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: JOSEPH SELVARAJ, RAJEE
FACILITY NUMBER: 013422617
VISIT DATE: 09/30/2024
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At 11:30AM, LPA tested the smoke detector (hallway) and the carbon monoxide detector (near front door) and found them to be functioning properly. The home also has a first aid kit, a working telephone, and a fully charged 3A40BC fire extinguisher which meets standards established by the State Fire Marshal located near the kitchen. All required forms are posted and visible for public review. LPA asked the licensee does she transports children and the licensee stated that she does not transport children. Licensee confirmed she resides in the home.

At 12:00PM, LPA requested and reviewed four (4) children files and personnel files. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The facility roster was review and copies were obtained. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires on 09/28/26. The licensee has completed mandated reporter training on 04/10/2024. Per licensee there are no firearms of any kind in the home.



Effective August 1, 2003, California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. The licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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 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: https://www.ada.gov/resources/child-care-centers/.



Per licensee does not administer medication at this time.


See 809-C.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: JOSEPH SELVARAJ, RAJEE
FACILITY NUMBER: 013422617
VISIT DATE: 09/30/2024
NARRATIVE
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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-andresources/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 that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

The licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE, Rajee Joseph Selvaraj, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Appeal Rights Provided. Exit interview conducted and report was reviewed with the licensee, Rajee Joseph Selvaraj.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
LIC809 (FAS) - (06/04)
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