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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700159
Report Date: 06/14/2023
Date Signed: 06/14/2023 11:00:14 AM

Document Has Been Signed on 06/14/2023 11:00 AM - 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:BHALANI, HIRALBENFACILITY NUMBER:
015700159
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 2CENSUS: 2DATE:
06/14/2023
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Hiralben BhalaniTIME COMPLETED:
11:05 AM
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On June 14, 2023 at approximately 8:30am licensing Program Analyst (LPA) Russ Haderer arrived for a pre-arranged announced visit with licensee Hiralben Bhalani for the purpose of changing the license from inactive to active status. Living in the home is the licensee, her TB test and fingerprint cleared husband and two adolescent children. Present for today’s inspection was licensee, her fingerprint and TB husband, two children and the licensees visiting father-in-law. The hours of operation are Monday-Friday, 8:30am to 6:00pm (occasionally it will be open until 11:00pm for parent’s night out).

LPA and the licensee toured the facility to review for health and safety. There is a 2A10BC fully charged fire extinguisher attached to the wall near the entrance to the facility and a working and tested smoke alarm and carbon monoxide detector. Licensee is up to date with CPR/1st aid training that; expires on 5/29/2025. Mandated Reporter certificate was renewed on 5/10/2023. Licensee is in compliance with immunization requirements for Title 22.

The facility is a single-story home with a front and back yard area and an attached 2-car garage. The garage has been converted for childcare and a ½ bath was added. Childcare will be provided in the former garage, but children will not eat or sleep in there. Portable heaters provide heating for the winter months. Children will nap and eat in the family room of the home.

On-limit areas include: The converted two-car garage (day care area), the ½ bathroom in the garage daycare room; Family room; and the fenced backyard with patio and side yards, and the front yard grass area only (for picnics or family gatherings). The backyard area has a large grass area that the children will use, the planters will be off limits to children. The day care area contains a washer and dryer and water heater, all with locked access doors for safety.

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SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2023
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 2
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: BHALANI, HIRALBEN
FACILITY NUMBER: 015700159
VISIT DATE: 06/14/2023
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Off-limit areas include: The kitchen; living room, all three bedrooms, master and house bathrooms. The off-limit kitchen will have a gate for additional precaution to prevent children from entering the room. All off limit doors in the home have child proof locks to prevent entry, and all other off-limit areas are made inaccessible by closed and/or locked doors, and/or by child supervision. In the backyard area there are perimeter planters, two adult swing chairs and a locked garden shed that are off limits to children.

This home is recommended for Active Status as of today, June 14, 2023.



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

Exit interview conducted and report was reviewed with licensee Hiralben Bhalani.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023
LIC809 (FAS) - (06/04)
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