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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013422774
Report Date: 09/23/2022
Date Signed: 09/23/2022 10:31:30 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/02/2022 and conducted by Evaluator Russell Haderer
COMPLAINT CONTROL NUMBER: 52-CC-20220902103911
FACILITY NAME:KUPPUSWAMY, HEMA MUTHULAKSHMIFACILITY NUMBER:
013422774
ADMINISTRATOR:KUPPUSWAMY, HEMA MUTHULAKSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(972) 979-5658
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:14CENSUS: 5DATE:
09/23/2022
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Hema KuppuswamyTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Physical Plant
INVESTIGATION FINDINGS:
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On September 23, 2022 at approximately 8:45am, Licensing Program Analyst (LPA) arrived unannounced to meet with licensee Hema Kuppuswamy regarding the open complaint allegation of an accessible tomato plant in the back yard and 25lb dumbbell weights on the backyard patio. There were 5 children in care.

On September 8, 2022 LPA observed the tomato plant and the dumbbell weights on the patio. The dumbbells on the patio were 25lb each, LPA lifted them and determined a child would not be able to pick them up. However, they can be a tripping hazard.

Tomato plants have small thorns and leaves contain the alkaloids tomatine and solanine and these things can cause allergic reactions and eating leaves can be harmful.

Based on LPAs observations, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1 regulation number 102417(g), are being cited on the attached Technical Assistance.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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