<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422765
Report Date: 02/06/2024
Date Signed: 02/06/2024 11:56:27 AM

Document Has Been Signed on 02/06/2024 11:56 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:RAVEENDRA, SHANTHALAFACILITY NUMBER:
013422765
ADMINISTRATOR:RAVEENDRA, SHANTHALAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 400-9582
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
02/06/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:26 AM
MET WITH:Shanthala Raveendra- LicenseeTIME COMPLETED:
12:05 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 2/6/24 at 11:26am, Licensing Program Analyst Briana Plumboy met with licensee Shanthala Raveendra for an UNANNOUNCED POC INSPECTION. Present for this visit was 1 infant, 9 preschool age children, and fingerprint clear and associated assistant Pinderjit Kaur. The licensee is in ratio during today's inspection. The home was toured.
LPA Plumboy cleared licensee's deficiencies cited on 1/31/24 for the facility being over capacity.

There are no deficiencies cited today. Copy of Cleared POC letters were provided. An exit interview was conducted. This report must be available for review for 3 years. A notice of site visit was posted. Notice of site visit must remain posted for 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2024
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 1