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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700143
Report Date: 07/09/2024
Date Signed: 07/09/2024 04:16:40 PM

Document Has Been Signed on 07/09/2024 04:16 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:HASSAN GURUPRASAD, JYOTHIFACILITY NUMBER:
015700143
ADMINISTRATOR/
DIRECTOR:		HASSAN GURUPRASAD, JYOTHIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 784-2623
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
07/09/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:05 PM
MET WITH:Jyothi Hassan GuruprasadTIME VISIT/
INSPECTION COMPLETED:
04:30 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 07/09/2024 at 3:05PM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted an unannounced Plan of Correction Visit. LPA met with Licensee Jyothi Hassan Guruprasad. Also present for the visit were 4 infants and 4 preschool aged children.

When LPA arrived Licensee was the only adult present in the home. Her assistant was out of the home at lunch. When the assistant is not present the home is to operate with the capacity of a small with no more than 3 infants present. At 3:30PM one infant was picked up by their parent and at 3:45PM Licensee's assistant arrived to the home.

On 06/26/2024, LPA conducted a annual/random visit. The Family Child Care Home (FCCH) was cited 1 Type A citations for being out of ratio by having 5 infants present in the home. The FCCH was also cited 2 Type B citations for infant safe sleep.

The Licensee and LPA developed a Plan of Correction (POC) with submission due date of 06/27/2024 for the Type A and LPA conducted a POC visit to verify. Licensee has the LIC9224 completed and has them in the children's files. The Licensee and LPA developed a Plan of Correction (POC) with submission due date of 07/3/2024 for the Type B citations and Licensee submitted POC by the due date.

There was one deficiency cited during today's inspection. See 809-D for deficiency.

LPA Jackson informed Facility Representative that this report dated 7/9/2024 document 1 Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/09/2024
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 3
Document Has Been Signed on 07/09/2024 04:16 PM - It Cannot Be Edited


Created By: Jaleesa Jackson On 07/09/2024 at 03:23 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: HASSAN GURUPRASAD, JYOTHI
FACILITY NUMBER: 015700143

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/10/2024
Section Cited
CCR
102416.5(e)

1
2
3
4
5
6
7
If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
1
2
3
4
5
6
7
Licensee will review the video on ccld.childcarevideos.org "How Many Children Can Attend a Family Child Care Home." Licensee will submitt a signed statement on how she will maintain ratio moving forward.
8
9
10
11
12
13
14
Based on observation and record review, the licensee did not comply with the section cited above in the licensee did not have an assistant present with 4 infants and 4 preschoolers and was not operating as a smalle which poses an immediate health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Jason Jang
LICENSING EVALUATOR NAME:Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:
DATE: 07/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/09/2024


LIC809 (FAS) - (06/04)
Page: 2 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HASSAN GURUPRASAD, JYOTHI
FACILITY NUMBER: 015700143
VISIT DATE: 07/09/2024
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
Also, LPA Jackson informed the Facility Representative that the licensee to provide a copy of this licensing report dated 7/09/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

LPA generated a Letter of Deficiency Citations Cleared and provided a copy to the Licensee.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Jyothi Hassan Guruprasad.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3