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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421812
Report Date: 12/08/2023
Date Signed: 12/08/2023 03:10:47 PM

Document Has Been Signed on 12/08/2023 03:10 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:SANGHVI, SAPNAFACILITY NUMBER:
013421812
ADMINISTRATOR:SANGHVI, SAPNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(224) 425-0526
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
12/08/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Sapna SanghviTIME COMPLETED:
03:15 PM
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On December 8th, 2023 at approximately 12:35pm, Licensing Program Analyst (LPA) April Wright arrived for an Unannounced Required 3 Year Inspection and met with licensee Sapna Sanghvi. LPA disclosed the purpose of the inspection and was granted entry into the home by the licensee. The home was toured for a health and safety inspection. Present during inspection were 13 children (11 preschool/school age / 2 infants) and fingerprint cleared assistant Hetalben Modi. Hours of operation are 8:15am - 6:00pm Monday through Friday.

The two story home consists of 3 bedrooms, 2 1/2 bathrooms which includes master bathroom, Living room, Kitchen/Dining area, backyard and garage. The home was neat and orderly, with heating and ventilation for safety and comfort of children in care. There is a gate at the bottom of the stairs to prevent access to the upper level of the home. There are no pools, hot tubs or any other bodies of water present in the on limit areas during todays inspection.

On limit areas include: Living Room, Dining Area, half bathroom (left of entry to home) and Backyard.
Off-limits areas: All 3 bedrooms including master bathroom, common bathroom, Kitchen and Garage.
Isolation area: Living room - a section away from other children in care.

The off limits area will be made inaccessible by closed and/or locked doors and visual supervision. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection. There are age appropriate toys that appear to be safe and in good condition. The home has a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, fully stock First Aid Kit, and telephone. There is a fireplace in that a screen with glass doors which is blocked/locked and is inaccessible to children in care. Per licensee there are no weapons or firearms in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers.

See LIC809 -C for continuance
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2023
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: SANGHVI, SAPNA
FACILITY NUMBER: 013421812
VISIT DATE: 12/08/2023
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LPA requested and reviewed the files of 7 children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The facility roster was review and copies were obtained. The licensee conducts fire and disaster drills twice a year and the last was conducted on 10/16/2023. The licensee has current CPR/First aid certificate which expires on 9/23/25. Licensee Mandated Reporter Training on expired 7/13/2023. No proof of completion or renewal is on file. The licensee is in ratio today. All required forms are posted and visible for public review.

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.

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-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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP . 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: https://www.ada.gov/resources/child-care-centers/

See LIC809C for continuance..

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023
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: SANGHVI, SAPNA
FACILITY NUMBER: 013421812
VISIT DATE: 12/08/2023
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

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.

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

Deficiencies Issued Today: Please see attached Deficiency & Advisory Note pages for additional information.

Type A Violation: Licensee did not have current Mandated Reporter Training on file or proof of renewal or completion.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/08/2023 03:10 PM - It Cannot Be Edited


Created By: April Wright On 12/08/2023 at 02:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SANGHVI, SAPNA
FACILITY NUMBER: 013421812

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in which Mandated reporter training certificate expired 7/13/2023, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/11/2023
Plan of Correction
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Licensee will complete Mandated Reporter training by due date provided.
Type A
Section Cited
HSC
1596.8662(c)
Administration of Child Day Care Licensing
(c) Current proof of completion for each licensed child day care provider or applicant for that license, administrator, and employee of a licensed child day care facility shall be submitted to the department upon inspection of the child day care or upon request by the department.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in which the Licensee had not renewed and no proof of completed Mandated Reporter training which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/11/2023
Plan of Correction
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Licensee will provide proof of completed training by submitting training certificates to LPA by the due date provided.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Chandra Charles
LICENSING EVALUATOR NAME:April Wright
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2023


LIC809 (FAS) - (06/04)
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