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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700300
Report Date: 07/01/2024
Date Signed: 07/01/2024 10:52:50 AM

Document Has Been Signed on 07/01/2024 10:52 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:SINGH, KIRANFACILITY NUMBER:
015700300
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
07/01/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Kiran SinghTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 07/01/2024 at 9:55AM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted an unannounced Plan of Correction Visit. LPA met with Licensee Kiran Singh. Also present in the home were the Licensee's fingerprint cleared husband, their 2 minor children, 3 preschool aged children, and 2 infants.

On 06/18/2024, LPA conducted a annual/random visit. The Family Child Care Home (FCCH) was cited 1 Type A citations for being out of ratio.

The Licensee and LPA developed a Plan of Correction (POC) with submission due date of 06/19/2024 and LPA conducted a POC visit to verify. Licensee has the LIC9224 completed and has them in the children's files.

LPA generated a Letter of Deficiency Citations Cleared and provided a copy to the Licensee.

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

Exit interview conducted and report was reviewed with the Licensee Kiran Singh.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2024
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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