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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394501043
Report Date: 03/20/2025
Date Signed: 03/20/2025 12:06:18 PM

Document Has Been Signed on 03/20/2025 12:06 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:SHIVANI, BHAVANAFACILITY NUMBER:
394501043
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
03/20/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Bhavana ShivaniTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 03/20/25, Licensing Program Analyst (LPA) Corina Beckby conducted a Case Management visit for the purpose of increasing the licensed capacity from 8 to 14 children. LPA met with Licensee, Bhavana Shivani. Licensee was present supervising 6 daycare children including 2 infants (ages 2 yrs old, 2 yrs old, 3 yrs old, 3 yrs old and 23 ms and 20 ms.) LIC (126), Entrance Checklist for Family Child Care Homes, was provided and reviewed with Licensee. Facility hours of operation are Monday through Friday 8:00 am to 6:00pm. Licensee has also applied to increase her capacity from a Small Family Child Care Home to a Large Family Child Care Home. Fire clearance was granted by South County Fire Authority Community Risk Reduction on 02/26/25. LPA verified the annual fees are current. All individuals subject to criminal background review have obtained a criminal record clearance.

During the inspection, Licensee requested an area of the backyard be off limits, starting at the garden area. LPA toured the backyard and granted the request. As of today, the areas of the backyard that are on limits is the patio area beginning from the sliding door to the back of the fence. The off-limit areas are the left and right side of the yard. The right side off limits begins with the garden area all the way to the fence.
Current CPR & First Aid was verified and expires on 03/01/27. Mandated Reporter expires on 01/04/26. LPA reviewed large family childcare home capacity limitations with licensee and documents needed for employees.

A health and safety inspection was conducted in all areas accessible to children. Home appears orderly and suitable for children. Off-limit areas are: 2nd floor, garage, kitchen, pantry, storage closet, front yard, left side and right side of backyard starting at the garden area to the fence. Hazardous items were stored inaccessible to children. Napping equipment and age-appropriate toys were observed. Licensee stated there are no weapons in the home. Home has a working telephone, a 2A10BC fire extinguisher, and functioning smoke and carbon monoxide detectors. The backyard is fenced for supervision. Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.



Continued on LIC 809-C...
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: SHIVANI, BHAVANA
FACILITY NUMBER: 394501043
VISIT DATE: 03/20/2025
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Capacity increase is approved as of today, 03/20/2025. The facility is licensed to serve a MAX. CAP (WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6. LICENSEE UNDERSTANDS THAT WHEN ASSISTANT IS NOT PRESENT, THE CAPACITY REVERTS TO A SMALL FAMILY CHILD CARE HOME.

An exit interview was conducted, and the report was reviewed with Bhavana Shivani to keep on file at the facility. License Appeal Rights were provided. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

No deficiencies were cited during today’s visit.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
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