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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700289
Report Date: 03/10/2026
Date Signed: 03/10/2026 01:00:07 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/06/2026 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20260306151309
FACILITY NAME:MODI, BHAVIKAFACILITY NUMBER:
015700289
ADMINISTRATOR:MODI, BHAVIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 784-5556
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:14CENSUS: 12DATE:
03/10/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Licensee, Bhavika Modi TIME COMPLETED:
01:15 PM
ALLEGATION(S):
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-Childcare staff/licensee did not seek timely medical care for child during an emergency
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation. LPA met with licensee Bhavika Modi and explained the purpose of the inspection. Present during today’s visit, Licensee and helper supervising 12 children.
Based on the interviews and information gathered, the incident occurred when C1 required medical attention. The facility took immediate action by notifying the parents and informing them of the situation; however, medical care was not obtained at that time. The preponderance of evidence standard has been met; therefore, the allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1, Section 102423 (a)(2), is cited on the attached LIC 9099D
Appeal rights were provided.
An exit interview was conducted with licensee Bhavika Modi.
A notice of site visit was posted and must remain posted for a period of 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 52-CC-20260306151309
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/20/2026
Section Cited
CCR
102423(a)(2)
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102423 Personal Rights
(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:(2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
This requirement is not met as evidenced by:
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The licensee will create a written Incidental Medical Services (IMS) plan, as required by Title 22, and submit it to Community Care Licensing. The plan will outline how the facility will provide and document IMS. Once completed, the licensee will ensure all staff are informed of the procedures.
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Based on the interviews, the licensee did not comply with the section above as medical care was not obtained which poses a potential risk to the health, safety, and personal rights of the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
LIC9099 (FAS) - (06/04)
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