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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393622645
Report Date: 03/21/2024
Date Signed: 03/21/2024 02:39:11 PM

Document Has Been Signed on 03/21/2024 02:39 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KUKKUNURU, KAVITHAFACILITY NUMBER:
393622645
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
03/21/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Kavitha KukkunuruTIME COMPLETED:
03:00 PM
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On March 21, 2024, Licensing Program Analyst (LPA) Stacey Williams met with Licensee, Kavitha Kukkunuru for the purpose of a case management inspection to increase capacity of licensure. Licensee requested a capacity increase to 14 children. LPA observed six children in care during today’s inspection.

LPA and Licensee toured the two story 3 bedroom home. Off-limit areas include: entire upstairs and the garage. Licensee acknowledged that children may never enter these off-limit areas. Licensee stated there are no new residents in the home since licensure. All Adult residents have criminal record clearances.

Community Care Licensing Sacramento South (Childcare Program) received a fire safety inspection clearance, and the home has been cleared for up to 14 children. Fire clearance has been approved by French Camp McKinley Fire FPD on 3/12/24. Large family childcare home capacity limitations were reviewed during today's inspection.

Because the Licensee rents the home . LPA did not observe a signed the Property Owner/Landlord Notification form (LIC9151). Licensee understands that she is not to provide care for more than 12 children without a signed LIC 9151 on file.

LPA conducted a health and safety inspection during today’s inspection. LPA observed cleaning supplies properly stored out of reach of children. LPA observed medications out of reach of children. Fire extinguisher (2A10BC), smoke detector, and carbon monoxide meet regulation. Toys appear to be clean and safe.



Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.

Licensee stated there are no weapons or pets in the home. There are no bodies of water on the property. Applicant understands the smoking prohibition for childcare.

LPA reviewed Licensee’s file during today’s inspection. LPA observed current CPR/First Aid certificate for Licensee with an expiration date of 12/2025. Mandated Reporter training is also current. Licensee understands that both cpr/first aid and mandated reporter training shall be renewed every two years. Child files were also reviewed and found to contain required licensing documents. Facility roster is current and fire drills are current.

Report Continues on LIC 809-C
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2024
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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: KUKKUNURU, KAVITHA
FACILITY NUMBER: 393622645
VISIT DATE: 03/21/2024
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All adults subject to criminal background review have obtained criminal record clearance. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs 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. LPAs discussed the requirement to check and log infant napping every 15 minutes, for infants under 24 months and under 24 months. LPAs provided a copy of LIC 9227 Individual Sleeping Plan, for infants under 12 months.

IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

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.

Effective today 3/21/24, facility is approved for a Large Family Child Care License to serve 12 children (when there is an assistant present) with no more than 4 infants. Without assistant, the ratios revert to those for small family childcare home. Property Owner/Landlord Consent form not on file.

Exit interview conducted and report was reviewed with the Licensee, Kavitha Kukkunuru.

Notice of site visit was given 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: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024
LIC809 (FAS) - (06/04)
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