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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419001
Report Date: 08/21/2023
Date Signed: 08/21/2023 01:21:47 PM

Document Has Been Signed on 08/21/2023 01:21 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:DIXIT, JAYANTIFACILITY NUMBER:
013419001
ADMINISTRATOR:DIXIT, JAYANTIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 931-1305
CITY:PLEASANTONSTATE: CAZIP CODE:
94588
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
08/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Jayanti DixitTIME COMPLETED:
01:30 PM
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On August 21, 2023 Licensing Program Analyst (LPA) Lorraine Dacanay Breaux arrived for an unannounced 1-year Required Inspection, and met with Licensee Jayanti Dixit. Present for this inspection were fingerprint cleared daughter D. Dixit. There were four (4) children in care today (1 infant and 3 toddlers). The home was toured inside and outside with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8:00 am to 6:00pm.

ON LIMITS: Entire home and backyard. OFF LIMITS: Garage. The Off limit areas are inaccessible by closed and/or locked doors and visual supervision. ISOLATION AREA: Living room area away from the children in care until the parents pick up.

The home is single story, 3 bedrooms and two bathroom, which is neat and clean, with heating and ventilation for safety and comfort. The outdoor play area is fenced, and is free from defects and dangerous conditions. There were age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. Fully charged fire extinguisher 3-A-40BC located in the living room, and working carbon monoxide and smoke detectors (tested and functioning). The fireplace is located in the front living room, it is screened to prevent access by children. Per licensee, there are no firearms and no pets in the home.

Records: At approximately 11:20 AM, LPA Breaux reviewed one child's file and personnel records. Individual Infant Safe Sleep Plans and Infant Sleep logs for sleeping infants were discussed and licensee provided a sample of the sleep log for reference. There is a current roster available for review and a copy obtained. The facility does not have liability insurance and Affidavit Regarding Liability Insurance forms (LIC 282) were reviewed and in the file. Staff interview also conducted and documented. Licensee mandated reporter training was completed and reviewed, reminded to renew every two years. Licensee was reminded to visit www.mandatedreporterca.com for the training. Licensee CPR/First Aide is current and expires on 07/16/2024 and Mandated Reported training was completed on 07/13/2022.

***Continued on LIC809C...
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 08/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/21/2023
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: DIXIT, JAYANTI
FACILITY NUMBER: 013419001
VISIT DATE: 08/21/2023
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The licensee is in compliance with the immunization laws. The licensee conducts and documents fire and disaster drills twice a year and the last conducted drill was on 07/07/23. All required forms are posted and visible for public review.

Provider Information Notices (PINs) & Quarterly Updates: 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 communication platform. To receive important licensed related information to licensed facilities, visit the CCLD website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email notifications.

CCLD Inspection Process: To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Criminal Record Clearance: 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.

MyChildCarePlan.org: Licensee was informed of the MyChildCarePlan.org website; 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.

Page 2 of 3 ***Continued on LIC 809-C***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: DIXIT, JAYANTI
FACILITY NUMBER: 013419001
VISIT DATE: 08/21/2023
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Safe Sleep: LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep website page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

During the exit interview, the LICENSEE Jayanti Dixit, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Incidental Medical Services (IMS): 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/resources/child-care-centers/.

Consultation: During today's visit, LPA Dacanay Breaux consulted licensee on staff and children's files.

No deficiencies found during today's inspection. Advisory Notes issued today:

  • Technical Violation: Licensee's did not have sleep log for infants.
  • Technical Violation: Children's files need to have Safe Sleep Plan and medical consent forms.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights Provided. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the licensee, Jayanti Dixit.

Page 3 of 3 ***End of Report***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2023
LIC809 (FAS) - (06/04)
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