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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700285
Report Date: 12/08/2022
Date Signed: 12/08/2022 10:36:50 AM


Document Has Been Signed on 12/08/2022 10:36 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:SINGH, SWATIFACILITY NUMBER:
015700285
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
12/08/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Swati SinghTIME COMPLETED:
11:15 AM
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On December 8, 2022 at approximately 09:15 AM, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux met with Licensee Swati Singh for an ANNOUNCED CASE MANAGEMENT - OTHER- CAPACITY INCREASE INSPECTION. Present for this visit was licensee S. Singh and licensee's fingerprint cleared assistant Deepthi Kodusu, and five (5) children, one (1) infant and four (4) preschool age children. The home was toured to conduct a Health and Safety Inspection. Hours of operation is Monday - Friday 8:30 am - 5:00 PM.

On-limit-areas include: Entryway of the home, living room, dining room, kitchen, master bedroom and bathroom (used for child care), hallway leading to master bedroom. The rear yard that is fully fenced. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits areas.

Off-limit-areas include: Three bedrooms down the hallway, bathroom in the hallway (main house bathroom), the attached 2-car garage, the front yard of the home, and the locked shed in the back yard. The off-limit areas will be inaccessible by closed and/or locked doors, child safety gates and/or by adult visual supervision.

This one story home which consists of four bedrooms, two bath, kitchen, garage, backyard, living and dining room. The home is neat and clean with heating and ventilation for safety and comfort. The ISOLATION AREA will be the living room away from children in care.

Children rooster reviewed and obtained a copy. Facility file reviewed and discussed with licensee. The outdoor play area is the fully fenced backyard and LPA observed that it is free from defects or dangerous conditions.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SINGH, SWATI
FACILITY NUMBER: 015700285
VISIT DATE: 12/08/2022
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All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

A fire clearance was approved on 11/09/2022 by the Livermore - Pleasanton Fire Department. Per Fire Clearance garage is off limits to children.



There are no deficiencies cited today. Notice of Site visit was provided to the licensee to be posted for the next 30 days. Appeal rights provided. Exit interview conducted and report was reviewed with the licensee, Swati Singh.

Based on the approval of the fire clearance, issuance of license is recommended for this home effective today. Licensee is approved for the Change of Capacity as of 12/8/2022.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2