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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700236
Report Date: 04/09/2024
Date Signed: 04/09/2024 01:34:28 PM

Document Has Been Signed on 04/09/2024 01:34 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:MEHRA, SUMEDHA & TARUNFACILITY NUMBER:
015700236
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
04/09/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Licensee Mehra, Sumedha and Tarun TIME VISIT/
INSPECTION COMPLETED:
01:40 PM
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 On 04/09/2024, LPA Saini conducted a subsequent case management inspection visit regarding the civil penalty issued on 12/13/2023. During the inspection, the licensee and helper were supervising three (3) preschoolers and one( 1)infant. On 12/13/2023, the facility was cited, and a civil penalty was assessed since the children were left with individuals (house cleaners) whose fingerprints were not cleared. It was found that two individuals were in violation, yet a civil penalty was issued for only one individual.

On 04/09/2024, CIVIL PENALTY ASSESSMENT—CAREGIVER BACKGROUND CHECK LIC421BG was created from the initial citation ( LIC809-D) issued on 12/13/2023 to amend the Civil penalty amount.



Exit interview was conducted and report was reviewed with the licensee Mehra, Sumedha,and Tarun.

A site visit notice was given and must remain posted for 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2024
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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