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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700289
Report Date: 10/23/2024
Date Signed: 10/23/2024 02:50:29 PM

Document Has Been Signed on 10/23/2024 02:50 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:MODI, BHAVIKAFACILITY NUMBER:
015700289
ADMINISTRATOR/
DIRECTOR:		MODI, BHAVIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 784-5556
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
10/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Licensee, Bhavika Modi TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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The Licensing Program Analyst (LPA) Jyoti Saini met with the licensee Bhavika Modi for an unannounced annual random inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during this inspection were the licensee and a helper supervising one (1) infant, eleven (11) preschoolers, and one (1) school-age child. The home is a duplex consisting of three bedrooms, two and a half bathrooms, a living room, a kitchen, a garage, and a backyard. The hours of operation are from 8:30 AM to 6:00 PM, Monday through Friday. The facility has liability insurance through Markel Insurance.
On-limits areas are: kitchen, living room and first bedroom on the right-hand side in the hallway and backyard. Off-limits areas: garage, the master bedroom, two full bathrooms and the office area at the end of the hallway. All the off-limit areas are made inaccessible to children by locked doors, safety gate and visual supervision.

The living room in the house functions as the primary daytime activity area, equipped with age-appropriate toys for the children.The dining area in the kitchen features a child-sized table and chairs. The home is equipped with a working telephone, a functioning smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. During today’s inspection, the LPA did not observe any bodies of water or a fireplace in the house. Each child has a separate cot with bedding. The licensee states that the bedding is sent home weekly to be washed. The licensee also confirms that there are no guns or weapons of any kind in the home. There are no pets. The outdoor play area is fenced and has plenty of age-appropriate toys and equipment for the children in care. The play yard includes a set of two swings that are securely bolted. The log indicates that the last fire and earthquake drill was conducted on 09/27/2024. The licensee and helper have current CPR and mandated reporter certificates on file. The licensee provides daily snacks and meals. LPA reviewed the children’s files, which are all complete and up to date. All required postings are properly posted. Licensee has a record of 15 minutes sleep check.


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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
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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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: MODI, BHAVIKA
FACILITY NUMBER: 015700289
VISIT DATE: 10/23/2024
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During Inspection, Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.



Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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

There is no deficiency cited today.

Exit interview conducted and report was reviewed with the licensee, Bhavika Modi.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC809 (FAS) - (06/04)
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