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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412078
Report Date: 01/11/2024
Date Signed: 01/11/2024 03:14:22 PM

Document Has Been Signed on 01/11/2024 03:14 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:AGRAWAL, SARIKAFACILITY NUMBER:
434412078
ADMINISTRATOR:AGRAWAL, SARIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 306-1927
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
01/11/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Sarika AgrawalTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Mel Matos met with Sarika Agrawal, Licensee, for an unannounced case management inspection. LPA also observed ten day care children (2 infants & 8 preschool) and one adult assistant (Pallavi Yadlapalli) in the home during today's inspection.

LPA notes that the Licensee has a pending application for a child care center license (Kinderwave LLC #434417145). Licensee states that she and her husband are currently working with the landlord of the facility regarding some matters that need to be resolved within the Facility at this time. Licensee states that her husband spoke with LPA Kaur via telephone and advised her of the situation.

Licensee states that she and her husband also received a Notice of Incomplete Application from LPA Kaur last week and are currently working on getting the required items submitted to her.

Licensee understands that a prelicensing inspection will not be scheduled for the new facility until her application is complete and the department has received an approved fire inspection request from the Sunnyvale Department of Public Safety.

Exit interview conducted and report was reviewed with the Licensee, Sarika Agrawal. No deficiencies issued during today's inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2024
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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