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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422924
Report Date: 11/29/2022
Date Signed: 11/29/2022 01:28:13 PM

Document Has Been Signed on 11/29/2022 01:28 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:CHINTA, LAKSHMIFACILITY NUMBER:
013422924
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/29/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Lakshmi ChintaTIME COMPLETED:
01:45 PM
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On 11/29/2022 approximately at 12:10PM Licensing Program Analyst (LPA) Kelly Phan arrived for an unannounced case management visit to change facility status from inactive to active, and met with Licensee Lakshmi Chinta. There were no children present today. Also residing in the home is the licensee's fingerprinted and associated husband and their two children (11 and 7). The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8:30am to 6:00pm.

ON LIMITS: first right-side bedroom #1 (isolation area), bathroom nearest to the dining room, dining room, living room, backyard, and kitchen
OFF LIMITS: garage, bedroom #2, bedroom #3, bedroom #4, master bathroom, and both side yards. Off limit areas are inaccessible by closed and/or locked doors

The home is single story, which is neat and clean, with heating and ventilation for safety and comfort. A child safety gate will be used at the kitchen area as the Licensee will use a gate to keep children in the dining room area. Per licensee, children will only use kitchen area as a walkaway to dining area. LPA observed there were age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. There was a fully charged 2A10BC fire extinguisher stored in the garage, smoke detectors, and telephone. Per licensee, she is not able to locate her carbon monoxide due to her recent paint job; LPA advised licensee that it is required to have at least 1 carbon monoxide in her home and will need to come back to ensure there is one and working before children are able to attend her day care. Licensee understood. There are no firearms or pets or smoking at the facility. Licensee does have a fire place, however it is closed off. Licensee has a worshipping area at the dining area but states she would use a gate/barrier to prevent access to children. Licensee was reminded to have required licensing documents posted and visible for public review. See LIC 809 C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2022
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: CHINTA, LAKSHMI
FACILITY NUMBER: 013422924
VISIT DATE: 11/29/2022
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LPA and licensee toured the backyard area and found that the area is safe and free of loose, sharp, or pointy objects. Licensee states that she would have a gate so children are not able to play around the gazebo area. There was no pools, hot tubs, or any bodies of water present at the facility.

LPA also reminded licensee to have both mandated reporter and CPR and First Aid training completed every 2 years. CPR and First aid card was valid from 08/20/2017 to 08/20/2019. Licensee is in the process of registering for a renewal class as soon as possible. LPA has given licensee a link to register for CPR and First aid trainings from an EMSA approved organization.

As of today, 11/29/2022 the facility is not ready to return to being active as a carbon monoxide is not present. Another visit will need to be conducted prior to January or February 2023 to ensure the home is ready for licensee to provide care to children at her home.

Appeal rights was given. Exit interview conducted and report was reviewed with licensee Lakshmi Chinta
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022
LIC809 (FAS) - (06/04)
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