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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700116
Report Date: 04/04/2023
Date Signed: 04/04/2023 12:08:49 PM

Document Has Been Signed on 04/04/2023 12:08 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:GUPTA, SANDHYAFACILITY NUMBER:
015700116
ADMINISTRATOR:GUPTA, SANDHYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 600-2637
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
04/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:SANDHYA GUPTATIME COMPLETED:
12:32 PM
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On April 4, 2023, Licensing Program Analyst Sidney Cortez, met with licensee SANDHYA GUPTA for an UNANNOUNCED ANNUAL RANDOM INSPECTION. Present for this visit was the licensee Sandhya Gupta, her fingerprint cleared husband Sunil Gupta, and one infant.The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:30AM until 6:30PM, MONDAY-FRIDAY.

This is a one-story home which consists of a living room/dining room, four bedrooms, a hallway bathroom, master bath, kitchen, family room, attached garage, and backyard. The home is neat and clean, with central heating and air conditioning. On-limit-areas include: family room (daycare area) and hallway bathroom and backyard.The ISOLATION AREA will be the bedroom first one to the right of the hallway. The Off-Limit areas: living room 3 bedrooms, bathroom in the masters bedroom, kitchen and garage. There are ample age appropriate toys, learning materials, and equipment that appear to be safe and in good condition. The home has a working smoke detectors, carbon monoxide detector, and First Aid Kit. LPA Cortez did not observe any bodies of water, hazardous materials, or toxins accessible to children. Per licensee, there are no firearms in the home


The home has a fully charged (3A40BC) fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee CPR and First Aid certificate is current and expires (SEPT 2024). The licensee's mandated reporter training is complete and will expire in (APRIL 2025) .
The licensee conducted fire and disaster on Jan 2023


1 Children files were reviewed (no children present/non operational at the moment), facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2023
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: GUPTA, SANDHYA
FACILITY NUMBER: 015700116
VISIT DATE: 04/04/2023
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The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility. Licensee was reminded of Departments inspection authority, with our without any notice.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. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care. Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, 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 For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list. This entire report has been read to the Licensee by LPA Cortez. The licensee is aware the signature on this report confirm receipt of these documents. LPA asked the licensee if the licensee had any questions pertaining to any aspects including, but not limited to, any part of this report and of the documents given to the licensee, and per licensee, there are no further questions at this time. Licensee is aware at anytime she can reach out to LPA Cortez or CCLD.


There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023
LIC809 (FAS) - (06/04)
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