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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423012
Report Date: 05/17/2022
Date Signed: 05/17/2022 03:37:47 PM

Document Has Been Signed on 05/17/2022 03:37 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:VAIDYA, DAKSHA DFACILITY NUMBER:
013423012
ADMINISTRATOR:VAIDYA, DAKSHA DFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 697-0006
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:01 PM
MET WITH:Daksha Vaidya- LicenseeTIME COMPLETED:
03:44 PM
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On 5/17/22 at 2:01pm, Licensing Program Analyst (LPA) Briana Plumboy arrived to the facility unannounced for an Annual/Random Inspection. LPA met with Licensee's fingerprint cleared spouse Ashish Gawarikar. Also present and residing in the home is the licensee's teenage daughter. During the inspection, licensee arrived at the home. The home was toured with the licensee's spouse to conduct a health and safety inspection. Currently the hours of operation are 9:00am to 12:30pm. During the school year the hours will be 9:00am to 5:00pm.

ON LIMITS: The entire home and backyard. Main day care room is the large room/bathroom addition on the right side of house. The isolation area will be in the living room.
Off LIMITS: Garage - Per fire clearance, day care is not approved in garage.

The home is a single story, and is neat and clean, with heating and ventilation for safety and comfort. The main outdoor play area is the enclosed area directly behind the day care room. There is a fence surrounding the perimeter of the backyard. There are toys and learning materials. There are no play structures present during todays inspection which are required to be anchored or cushioned underneath. Toxins, medicines, and hazardous items were inaccessible. The home has a fully charged 3A40BC fire extinguisher, working carbon monoxide/smoke detectors and telephone. The fireplace is screened, and has decorative pots inside. Per licensee, the fireplace is not used. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills, and log indicates drills were conducted 3/11/22. All required forms are posted and visible for public review. The licensee has proof of the required immunization's. Lic. 126 was provided to licensees spouse. Licensee provided LPA Plumboy with a copy of the current roster. Licensee Daksha Vaidya's CPR/First Aid certificate is current and expires 4/9/24.
See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: VAIDYA, DAKSHA D
FACILITY NUMBER: 013423012
VISIT DATE: 05/17/2022
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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 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

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensee Daksha Vaidya 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 Daksha Vaidya 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.

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Daksha Vaidya

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2022
LIC809 (FAS) - (06/04)
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