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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621011
Report Date: 03/15/2023
Date Signed: 03/15/2023 02:17:52 PM

Document Has Been Signed on 03/15/2023 02:17 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:KAIRAMKONDA, SARITHAFACILITY NUMBER:
393621011
ADMINISTRATOR:KAIRAMKONDA, SARITHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 281-2133
CITY:MOUNTAIN HOUSESTATE: CAZIP CODE:
95391
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
03/15/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH: Saritha Kairamkonda TIME COMPLETED:
02:38 PM
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On March 15, 2023, Licensing Program Analyst (LPA) Stacey Williams met with Licensee, Saritha Kairamkonda for the purpose of conducting a plan of correction inspection. LPA observed (14) fourteen children in care.

LPA discussed the plan of correction that was issued on 3/7/2023. Licensee stated that she reviewed Title 22 regulations with staff and has a clear understanding of ratio/capacity requirements for family childcare homes.

LPA reviewed report with Saritha Kairamkonda and provided copies of the report along with Appeal Rights. A notice of site visit was provided and posted by LPA Williams and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2023
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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