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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415903
Report Date: 11/03/2023
Date Signed: 11/03/2023 03:08:01 PM

Document Has Been Signed on 11/03/2023 03:08 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:CHOUDARY, ARTHIFACILITY NUMBER:
434415903
ADMINISTRATOR:ARTHI CHOUDARYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 646-2373
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
11/03/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Arthi ChoudaryTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mel Matos met with Arthi Choudary, Licensee, for an unannounced case management inspection. The day care was closed for the day; thus no day care children were present during today's inspection. LPA also observed Licensee's spouse, Rajiv Choudary, and Licensee's two minor children in the home during today's inspection.

Licensee states that she normally has two adult assistants and 12 day care children in care. LPA reviewed two adult assistants (Renu Yadav & Jayeeta Banerjee files during today's inspection.

LPA reminded the Licensee that all staff, including the Licensee, need to complete the Mandated Reporter Training for Child Care Workers every two years. Proof of immunization record for the Mmr, Tdap, and influenza (or opt out for influenza) need to be on file for all staff.

An Entrance Checklist - Family Child Care Homes (LIC 126) was provided to the Licensee prior to the conclusion of today's inspection.

Exit interview conducted and report was reviewed with the Licensee, Arthi Choudary. 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: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2023
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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