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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408419
Report Date: 08/07/2024
Date Signed: 08/07/2024 01:54:06 PM

Document Has Been Signed on 08/07/2024 01:54 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:SHRUTI, FNUFACILITY NUMBER:
073408419
ADMINISTRATOR/
DIRECTOR:		SHRUTI, FNUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 386-2180
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
08/07/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Shruti MahajanTIME VISIT/
INSPECTION COMPLETED:
02:05 PM
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On August 7, 2024 at 1:15pm, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced to conduct a POC (Plan of Correction) Inspection. LPA met with licensee Shruti Mahajan. Present were nine preschool age children and helper Asha Vinod.

Section 102417(g)(5) - Operation of a Family Child Care Home was cited on 7/19/2024 for the hot tub in sideyard not being secured shut with lock(s). LPA observed today that licensee has secured the hot tub cover with child proof locks. Deficiency is cleared today.

No other deficiencies cited today. A Notice of Site Visit was provided and must remain posted for 30 days.

Exit interview with licensee Shruti Mahajan. Copy of report and Letter of Deficiency Citations Cleared was provided.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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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