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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421071
Report Date: 10/11/2023
Date Signed: 10/11/2023 10:51:22 AM

Document Has Been Signed on 10/11/2023 10:51 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:NAGAR, ALPAFACILITY NUMBER:
013421071
ADMINISTRATOR:NAGAR, ALPAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 425-0061
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
10/11/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Alpa NagarTIME COMPLETED:
11:00 AM
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On 10/11/23, Licensing Program Analysts (LPAs) Lorraine Dacanay Breaux and Brittany Crass conducted an announced Case management inspection at the facility. Licensee requested that the rear yard be placed from off limits to on limits. LPS toured the facility for health and safety. LPAs met with licensee Alpa Nagar. Hours of operation is Monday - Friday 8:00 AM - 6:00PM.

This home is a two story home which consist of 4 bedrooms and 3 bathrooms.

On Limit Areas: Living room (fireplace is covered with glass screen), family room, kitchen, hallway leading to the bathroom, main bathroom on the first floor and the rear yard in front of the fence.

Off Limit Areas: One bedroom on the main level and the entire second floor which consist of three bedrooms and two bathrooms (including the master bedroom and bathroom) garage and laundry room.

Licensee was reminded that no water is to be put into the water fountain, if at a later date she decides to fill water LPA reminded Licensee that she will need at least a 5 foot gate and LPA will have to reinspect. As of today's inspection the water fountain was completely empty (no water). LPA provided a copy and discussed with the licensee the Regulations for swimming pools/bodies of water (ex: water fountain).There is a BBQ pit in the yard (uncovered) per licensee this is not used, and LPA observed. Licensee will send me photos by 10/11/23 via email showing it is covered and secured to prevent children's access.

Reminder: California Law requires Child Care Homes to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2023
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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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: NAGAR, ALPA
FACILITY NUMBER: 013421071
VISIT DATE: 10/11/2023
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Licensee is reminded that ALL adults, employees, and frequent visitors must be fingerprint cleared prior to being in the presence of children in care, or an immediate civil penalty will be assessed from $100 to $500 per person, per incident. Licensee had valid CPR/ First Aide which expires 03/24/25, and her mandated reporter training expires 03/15/24.

LPA discussed the safe sleep regulations with and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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 confirmed that there are no Registered Sex Offenders living in the facility. Notice of site visit was provided. Appeal Rights provided. Exit interview conducted with Licensee, Alpa Nagar.

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

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
LIC809 (FAS) - (06/04)
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