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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015701258
Report Date: 04/03/2025
Date Signed: 04/06/2025 05:16:36 PM

Document Has Been Signed on 04/06/2025 05:16 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:AMIN, DARSHANA & MANOJFACILITY NUMBER:
015701258
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/03/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:10 PM
MET WITH:Manoj and Darshana AminTIME VISIT/
INSPECTION COMPLETED:
03:05 PM
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On April 3rd, 2025 at approximately 12:10pm, Licensing Program Analyst (LPA) April Wright met with applicants Manoj and Darshana Amin for an announced Pre-licensing Inspection. There were no additional individuals or children present during the inspection. The home was toured for a health and safety inspection. Hours of operation will be Monday to Friday between 8:00am to 5:30pm.

The applicants’ single-story home was neat and orderly with heating and ventilation to provide safety and comfort. The home consists of four (4) bedrooms, two (2) bathrooms, Living/family room areas, dining room, kitchen, backyard and garage. The home has a 2A10BC fire extinguisher and has functioning carbon monoxide/smoke detectors in place. LPA reviewed documents that confirm the applicants have control of the property.

On Limits: Day care areas will consist of Living/family Room (daycare room), sick room (bedroom #2 to the left of the hallway), bathroom #1 (down hallway), and the entire backyard.

Off Limits: Remaining bedrooms #1 and #3, Master Bedroom (#4) and master bathroom, kitchen and garage. Off limits areas are made inaccessible by child safety gates and child safety locks to prevent access to those areas.

LPA observed the backyard was free from defects or dangerous conditions. There are age appropriate toys for the children to utilize and observed by the LPA to be free of visual defects or damage. LPA observed and applicants confirmed that there are no pools, hot tubs, or any other visible bodies of water on the premises. Applicants confirmed there are no pets located in the home.

See LIC809C for continuance.

NAME OF LICENSING PROGRAM MANAGER: Chandra Charles
NAME OF LICENSING PROGRAM ANALYST: April Wright
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/03/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: AMIN, DARSHANA & MANOJ
FACILITY NUMBER: 015701258
VISIT DATE: 04/03/2025
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Applicants have a firearm located in the home. LPA observed the firearm and ammunition are stored and secured separately. LPA observed and applicants confirmed that all hazardous materials, toxins and cleaning products are made inaccessible to children in care. Applicants have installed child safety locks on the cabinets, drawers and doors as observed by the LPA.

Applicants completed the Family Child Care Home Orientation on 1/27 and 1/30/2025. Applicant's Preventive Health and Safety training was completed on 2/23/2025. CPR/First Aid training certificates are current and will expire on 2//2027 and the Mandated Reporter training was completed on 2/12 and 2/13/2025. Applicants are following all immunization laws as it pertains to all day-care providers. A packet of forms pertaining to the children’s files and facility files were reviewed and discussed. LPA Wright discussed the Safe Sleep practices with applicant.

LPA Wright reminded the applicant of the following: Mandated Reporter training and CPR/First Aid training certificates must be renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. LPA discussed Unusual Incidents Reports with the applicant and when to report an incident. LPA discussed with the applicants that the Family Child care home licenses issued by CCLD are not transferable to any additional locations.

The applicant is also reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

LPA Wright provided a copy of Safe Sleep-in Child-Care brochure, a handout "What Does A Safe Sleep Environment Look Like?" and a copy of the new California Car Seat Law Changes. For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Applicants is reminded that all assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Applicant was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

See LIC809C for continuance.
NAME OF LICENSING PROGRAM MANAGER: Chandra Charles
NAME OF LICENSING PROGRAM ANALYST: April Wright
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2025
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: AMIN, DARSHANA & MANOJ
FACILITY NUMBER: 015701258
VISIT DATE: 04/03/2025
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Individual Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

This home is recommended for licensure. This report shall remain on file for 3 years. Report was reviewed and read with applicants Manoj and Darshana Amin.
NAME OF LICENSING PROGRAM MANAGER: Chandra Charles
NAME OF LICENSING PROGRAM ANALYST: April Wright
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2025
LIC809 (FAS) - (06/04)
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