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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700382
Report Date: 07/26/2024
Date Signed: 07/26/2024 10:26:09 AM

Document Has Been Signed on 07/26/2024 10:26 AM - 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:MUPPALLA, NAVYAFACILITY NUMBER:
435700382
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
07/26/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Licensee Navya MuppallaTIME VISIT/
INSPECTION COMPLETED:
10:35 PM
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On 07/26/2024 at 8:45 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Case Management Visit. LPA met with the Licensee Navya Muppalla and explained the nature of the visit. Present on this visit were the Licensee's Spouse, Licensee's Mother, Licensee's Tenant who is residing in the ADU (Accessory Dwelling Unit), Licensee's infant son, and 4 preschool children. The home operates from Monday to Friday, 8:30 am to 5:30 pm.

The Licensee submitted a Capacity Increase Application and received at the Regional Office (RO) on
07/02/24. The City of Milpitas Fire Department conducted a Fire Safety Inspection on 07/23/2024 and a Fire Clearance was granted on that day.

LPA toured the home to conduct a Health and Safety Inspection with the Licensee. The home is a one-story home. The home is neat and clean with central heating and ventilation for safety and comfort.

The On-Limit Areas are the Living Room, hallway bathroom and backyard. The backyard will be a designated outdoor play area that is fully fenced. The Bedroom 1 adjacent to the Living Room will be used for the designated Isolation Area when a child gets sick.

The Off Limit Area are the Kitchen, Master Bedroom with master bathroom, the Bedroom number 2 (Office room) adjacent to the Bedroom 1, the Bedroom 1, ADU Converted Garage and side yards. LPA discussed to the applicant that the Off Limit Areas will be inaccessible to children by locked doors, safety gates and visual supervision.

The home fireplace is blocked by a furniture to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted in January 2024 and June 2024.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: MUPPALLA, NAVYA
FACILITY NUMBER: 435700382
VISIT DATE: 07/26/2024
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The home does have a new fully charged 2A10BC fire extinguisher. The home has a working smoke detector and carbon monoxide. The home maintains telephone service which is a mobile phone. LPA observed child safety gates in the kitchen and the outdoor play area (backyard). There are ample age-appropriate toys that appear to be safe and in good condition. There are no pools, hot tubs or any other bodies of water present during today's inspection. All hazardous materials and toxins are kept out of the reach of children, and it was observed that there are no toxins or hazardous items accessible today.

Because the licensee rents/leases the home, proof of landlord notification is required. The LPA reviewed the Property Owner/Landlord Notification form (LIC9151) that the Licensee confirms was provided to the property owner/landlord. The Licensee obtained a signed Property Owner/Landlord Consent form (LIC 9149). The home does not carry childcare liability insurance or a bond and maintain the signed form LIC 282 AFFIDAVIT REGARDING LIABILITY INSURANCE.

The Licensee completed the Health and Safety training completed on 04/15/2023, and CPR (Pediatric) and First Aid completed in April 2023 with validity period of 2 years. The Licensee completed the AB1207 Child Care Providers training online on 04/14/2023 at https://mandatedreporterca.com/. LPA reminded the Licensee that AB1207 requires 2-year renewal. The Licensee has records of Measles and Pertussis immunization, Influenza declination statement and TB clearance. LPA reminded the Licensee that only the Influenza vaccination can be decline with a written declination. LPA reviewed the Children's Roster. Children’s files were reviewed, which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Infant Sleep Log, LIC 9150 and Immunization. The licensee is in ratio today. Licensee stated that she does not transport children at this time.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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

DATE: 07/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2024
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: MUPPALLA, NAVYA
FACILITY NUMBER: 435700382
VISIT DATE: 07/26/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/

LPA discussed the safe sleep regulations with licensee 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 licensee [or facility representative] 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 platforms.

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 now recommended for a Large Family Child Care Home (FCCH) License effective today, 07/26/2024.

A notice of site visit was given to and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.



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

DATE: 07/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2024
LIC809 (FAS) - (06/04)
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