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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700036
Report Date: 05/13/2022
Date Signed: 05/13/2022 02:46:45 PM

Document Has Been Signed on 05/13/2022 02:46 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:KAUR, KAMALPREET & SARN, RANJODHFACILITY NUMBER:
015700036
ADMINISTRATOR:KAUR, KAMALPREETFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 676-5744
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY: 14TOTAL ENROLLED CHILDREN: 16CENSUS: 8DATE:
05/13/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Kamalpreet KaurTIME COMPLETED:
03:06 PM
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On 5/13/2022, Licensing Program Analyst (LPA) Jonathan Williams arrived at the facility unannounced to verify correction of deficiency cited on 5/11/2022. LPA was met by Licensee, Kamalpreet Kaur, and one fingerprint cleared and associated staff member. Present for today's visit were eight children in care (four preschoolers and four infants).

On 5/11/2022, the facility was observed to be out of ratio, with 5 infants present out of 14 children present in the facility. Type A deficiency was cited. During today's visit, facility was observed to be in ratio, with 4 infants present out of 8 children present in the facility. Deficiency cleared.

Exit interview conducted. Appeal rights provided. Notice of site visit was given and must remain posted for a period of 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE: DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2022
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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