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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004781
Report Date: 09/27/2023
Date Signed: 09/27/2023 04:13:05 PM

Document Has Been Signed on 09/27/2023 04:13 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BASU, KASTURIFACILITY NUMBER:
414004781
ADMINISTRATOR:BASU, KASTURIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 303-9293
CITY:FOSTER CITY,STATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 3DATE:
09/27/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
04:08 PM
MET WITH:Kasturi BasuTIME COMPLETED:
04:30 PM
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On September 27, 2023, Licensing Program Analysts (LPA’s) Maria Olguin-Leon and Jonathan Tse, made an unannounced case management visit in conjunction with an annual visit. LPAs met with Kasturi Basu and explained the reason for the visit. Licensee requested to add a portion of the backyard to on limits area. Area is currently off-limits. Licensee is requested to add the white pebble area and adjacent grass area to on limit childcare area.

LPAs and the licensee inspected areas for potential health and safety hazards. Area is equipped with a small playhouse and swing set. Ground under swing is equipped with grass to cushion falls. Playhouse is in white pebble area. Licensee will be barricaded off limits grass area with an outdoor porch swing.

The LPAs will approval the addition of the backyard once Licensee removes ceramic tiles and barbecue pit from this area and properly barricades the reminder of off-limits backyard; Licensee will email photos of completed task to LPA for final approval.

A copy of this report, and the “Notice of Site Visit,” were given to the licensee. A “Notice of Site Visit” must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Licensee, Kasturi Basu.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2023
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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