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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422277
Report Date: 09/29/2022
Date Signed: 09/29/2022 11:26:33 AM

Document Has Been Signed on 09/29/2022 11:26 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:RATHI, SARIKAFACILITY NUMBER:
013422277
ADMINISTRATOR:RATHI, SARIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 556-7291
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
09/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sarika RathiTIME COMPLETED:
11:30 AM
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On September 29, 2022 at approximately 9:00am Licensing Program Analyst (LPA) Russ Haderer arrived unannounced and met with licensee Sarika Rathi for the purpose of conducting an annual inspection for health and safety. Living in the home is the licensee, her TB test and fingerprint cleared husband and two children. Present for today’s inspection was licensee and her fingerprint and TB cleared husband and assistant. Upon arrival there was 7 child in care, 1 more arrived during visit (3 infants, 3 two-years old; 1 three-years old; 1 four-years old). The facility is in ratio today. The hours of operation are Monday-Friday, 8:30am to 5:30pm.

The facility is a two-story townhouse with a small front and back yard area and a 1-car attached garage. There is a gate barrier to prevent children from entering the kitchen entry area of the home and staircase. All children are escorted to the bathroom and are never out of the care and supervision of the licensee or assistant. There is a fireplace in the living room, it is not in use and completely blocked by a children’s toy storage unit. Per licensee, there are no firearms in the home.

ISOLATION AREA will be in the home entry area away from other children in care. The child can be watched and taken care of in that area until their parent arrives.

The kitchen was added to the on-limits area and inspected for safety. No chemicals or hazardous items are accessible to children, knives are stored on the wall magnetic storage strip on the wall over the counter and out of reach to children.

On-limit-areas include: Living room, dining room, kitchen, down stairs ½ bath and enclosed backyard patio area.

Off-limit-areas include: The whole of the second story, 1-car attached garage. All off limit areas are inaccessible by closed and/or locked doors and visual supervision.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022
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: RATHI, SARIKA
FACILITY NUMBER: 013422277
VISIT DATE: 09/29/2022
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There is a fully charged 2A10BC fire extinguisher located in the kitchen. The facility has a working (tested) dual smoke and carbon monoxide detectors. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 6/2/2022. All required licensing documents are posted and visible for public review.

There were ample age appropriate toys that were observed to be safe and in good condition. The home is neat and clean, with heating and ventilation for safety and comfort. LPA did not observe any hazardous materials, or toxins accessible to children on the premises during the inspection.

Children's files were reviewed and found to be complete and in good order. The facility roster was reviewed, and a copy obtained. Facility files were reviewed, Licensee, and all adults living in the home are in compliance with immunization law which pertains to day care providers.

The licensee’s Pediatric CPR/First Aid certificate is current and expires 5/29/2023. Mandated reporter training completed 7/23/2022. LPA reminded the licensee of the following: CPR/1st Aid and Mandated Reporter training is to be renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.

The licensee owns the property and carries liability insurance through Acord in effect through 01/13/2023.



Licensee was reminded that all adults 18 and over living or working in the home, 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.

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

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
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: RATHI, SARIKA
FACILITY NUMBER: 013422277
VISIT DATE: 09/29/2022
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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 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.

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/inspection-process.

There were no deficiencies issued during today’s inspection: This report will remain on file for 3 years.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Sarika Rathi.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
LIC809 (FAS) - (06/04)
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