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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700367
Report Date: 08/23/2022
Date Signed: 08/23/2022 05:34:02 PM

Document Has Been Signed on 08/23/2022 05:34 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:SANGHAVI, AESHAFACILITY NUMBER:
435700367
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/23/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Aesha SanghaviTIME COMPLETED:
11:30 AM
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On Tuesday, August 23, 2022 9:00 AM, Licensing Program Analyst (LPA) Manel Estoesta conducted an announced Pre-Licensing Visit. LPA met with the Applicant Aesha Sanghavi and explained the nature of site visit. No other person or children present on this visit. The applicant has applied for Location Small Family Child Care Home (FCCH) Change Application and received on 08/04/2022. The Applicant's previous License number is 435 700 323. Hours of operation will be from Monday to Friday 8:30 AM to 6 PM.

LPA toured the facility to conduct a health and safety inspection. The home is a two-story home with four (5) bedroom, 2 & 1/2 bathrooms, living room, kitchen, dining area, garage and back yard. The home is neat and clean with central heating and ventilation for safety and comfort. The fireplace is blocked with a furniture to prevent access by children

The OFF-LIMIT AREAS are the entire second floor, dining, kitchen and garage will be inaccessible to children by locked doors, safety gates and visual supervision.

The ON-LIMIT AREAS are the Day Care Room 1 with a Bathroom, Day Care Room 2, Living Room, Hallway Bathroom located in the first floor and the backyard. The designated isolation area will be Living room. The backyard will be a designated outdoor play area that is fully fenced. The outdoor area has age appropriate toys that appear to be clean and free from defects and dangerous conditions. There are no pools, hot tubs or any other bodies of water. All hazardous materials and toxins are kept out of reach from children and are not accessible. The home has a does not have charged 2A10BC fire extinguisher, working smoke detector and carbon monoxide, working cell phone and fully stocked first aid kit. The applicant stated that there are no firearms on the premises.

SEE 809 C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SANGHAVI, AESHA
FACILITY NUMBER: 435700367
VISIT DATE: 08/23/2022
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Continuation.

The applicant completed the Health and Safety training with Lead Poisoning Prevention on 02/28/2021 and CPR (Pediatric) and First Aid completed on 04/23/2022 with validity period of 2 years. The applicant completed the AB1207 Child Care Providers training online at https://mandatedreporterca.com/ on 04/09/2022. LPA reminded the applicant that AB1207 requires 2-year renewal. The applicant has records of Measles and Pertussis immunization, Influenza vaccination and TB clearance. LPA reminded the applicant that only the Influenza vaccination can be decline with a written declination.

The applicant owns the home and has childcare liability insurance with Farmers Insurance. LPA reviewed the Farmers Insurance childcare liability insurance document dated 08/22/2022.



LPA reviewed with the applicant the LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Incidental Medical Services (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



Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 to the applicant the Guardian New User Information, PIN 22-10-CCP UPDATED GUIDANCE FOR CHILD CARE PROVIDERS REGARDING CORONAVIRUS DISEASE (COVID-19) and the Lead PUB 515.

SEE 809 C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SANGHAVI, AESHA
FACILITY NUMBER: 435700367
VISIT DATE: 08/23/2022
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Continuation.

LPA discussed the safe sleep regulations with the applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the applicant 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The home is recommended for a Small FCCH License effective today, Tuesday, August 23, 2022.



Exit interview conducted and report was reviewed with the applicant, Aesha Sanghavi.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
LIC809 (FAS) - (06/04)
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