<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700132
Report Date: 10/21/2022
Date Signed: 10/21/2022 03:20:36 PM

Document Has Been Signed on 10/21/2022 03:20 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:PRABAHAR, PARIMALAMFACILITY NUMBER:
015700132
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
10/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Parimalam PrabaharTIME COMPLETED:
03:25 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On October 21st, 2022 at 1:10PM, Licensing Program Analyst (LPA) April Wright met with licensee Parimalam Prabahar for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. There were no children present during today's inspection. Hours of operation are 8:30am - 5:30pm Monday through Friday.

LPA toured the facility to conduct a health and safety inspection. The single story home was clean and orderly, with heating and ventilation for safety and comfort of children in care.
On limit areas include: Kitchen, Living Room, Guest/Sick Room, Bedroom at the end of the hallway on the right side, Bathroom at the end of the hallway, Sunroom and Backyard
Off-limits areas include: Master Bedroom and Bathroom, 2 Bedrooms at beginning of hallway and Garage
Isolation Room: Guest/Sick Room

The off limits are and will be made inaccessible by closed and/or locked doors and visual supervision. There are no pools hot tubs or any other bodies of water present in the on-limit areas during today’s inspection. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection. There are ample age appropriate toys that appear to be safe and in good condition.

The home has a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detector (plugin), fully stock First Aid Kit. and telephone. There is a fireplace in that is locked and inaccessible to children in care. Per licensee there are no firearms in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers.

See LIC809 -C for continuance
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2022
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 3
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: PRABAHAR, PARIMALAM
FACILITY NUMBER: 015700132
VISIT DATE: 10/21/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA requested and reviewed the four (4) files of children in care. 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 facility roster was review and copies were obtained. The licensee conducts fire and disaster drills twice a year and the last was conducted on 10/20/2022. The licensee CPR/First aid certificate expired on 10/10/2022 and Mandated Reporter training was completed on 8/3/2022. The licensee is in ratio today. All required forms are posted and visible for public review.

Incidental Medical Services (IMS) policy was discussed. No IMS provided at facility. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

California Law requires Child Care Centers 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 is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

Licensee was reminded that all adults 18 and over, 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 childcare center. 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.



Please see below and attached advisory notes pages for additional information about technical violations issued today:
  • Technical Violation: Licensee CPR/First aid expired on 10/10/2022

There are no deficiencies cited. A notice of site visit was given and must remain posted 30 days. Exit interview conducted and report was reviewed with Licensee Parimalam Prabahar.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3