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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075700220
Report Date: 03/15/2024
Date Signed: 03/15/2024 02:34:29 PM

Document Has Been Signed on 03/15/2024 02:34 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:PADAKANDLA TIRUMALA, INDIRARAYALFACILITY NUMBER:
075700220
ADMINISTRATOR:PADAKANDLA TIRUMALA, INDIRFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 812-4785
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 9DATE:
03/15/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Indirarayal Tirumala Padakandla TIME COMPLETED:
02:33 PM
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On 3/15/2024 at 1:00pm Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Indirarayal Tirumala Padakandla for a Required – 3 Year Inspection. Present during the inspection was the Licensee, her helper and two (2) infants and seven (7) preschool age children. Licensee’s minor daughter and her helpers minor daughter were present in the home upstairs in an off-limit area. Licensee lives in the home with her husband, and minor daughter. The facility operates from 8:30am – 5:30pm, Monday – Friday.

ON LIMITS AREA: Living Room, Family Room, Dining Area, Downstairs Bathroom, and Backyard
OFF LIMITS AREA: Entire 2nd Floor, Kitchen, and Garage
ISOLATION AREA: Living Room

The facility is a two-story home owned by the Licensee. The inside of the home is observed to be neat, clean with ample age-appropriate materials for the children. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. Licensee stated they provide all food for the children which was observed to be properly maintained and stored. All food that may be brought from the children’s home will be properly labeled and stored. Licensee uses a child sized table in the dining area for eating that was observed to be clean and well maintained. All bedding was clean and properly stored. All off limit areas are made inaccessible with closed doors, locks, and gates. Licensee stated they do not transport children. Licensee stated there are no firearms and no pets in the home.

There is one (1) fully charged 3A40BC fire extinguisher in the kitchen. There is a pull-down fire alarm in the kitchen as well. There is one (1) working smoke detector in the hallway and the family room. There is a working carbon monoxide detector in the living room. The home is equipped with central heat and air for proper ventilation. The staircase is gated making it, and the 2nd floor, inaccessible to the children in care.
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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2024
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: PADAKANDLA TIRUMALA, INDIRARAYAL
FACILITY NUMBER: 075700220
VISIT DATE: 03/15/2024
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The electric fireplace in the family room is blocked by furniture making it inaccessible to the children in care. The backyard is fully fenced with ample age-appropriate materials for the children. There is a shed on the right side of the home that is gated off making it inaccessible. LPA did not observe any bodies of water in or around the home that could be a potential danger to the children in care.

The facility is operating within its licensed capacity and is out of ratio. Licensee’s Health and Safety training has been completed and EMSA approved Pediatric CPR & First Aid has been complete and expires 7/10/2024. Licensee’s Mandated Reporter training has expired as of 2/2024. Licensee was instructed to renew the training by 3/19/2024. Proof of completion will be sent to LPA. Fire/disaster drills have been conducted and recorded with the last drill logged 1/15/2024. All required forms are posted and visible for public view on the wall by the front door. LPA obtained the children’s files, helper's file, and facility files. All files were complete.

No deficiencies were cited during LPAs inspection.

Licensee was reminded that California law requires Licensees to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, Licensee’s must submit the Unusual Incident/Injury form (LIC 624B) to the Department. Licensee was reminded that any structural changes or additions to the home must be reported to Community Care Licensing. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting https://mandatedreporterca.com/. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov.



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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: PADAKANDLA TIRUMALA, INDIRARAYAL
FACILITY NUMBER: 075700220
VISIT DATE: 03/15/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, Licensee Indirarayal Tirumala Padakandla, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.


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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: PADAKANDLA TIRUMALA, INDIRARAYAL
FACILITY NUMBER: 075700220
VISIT DATE: 03/15/2024
NARRATIVE
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Exit interview conducted and report was reviewed with the Licensee Indirarayal Tirumala Padakandla.














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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5