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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422924
Report Date: 04/18/2023
Date Signed: 04/18/2023 10:39:51 AM

Document Has Been Signed on 04/18/2023 10:39 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:CHINTA, LAKSHMIFACILITY NUMBER:
013422924
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/18/2023
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Lakshmi ChintaTIME COMPLETED:
10:36 AM
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On 4/18/2023 at 9:15am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Lakshmi Chinta for an Annual/Random Inspection. Present during the inspection was the Licensee. Licensee currently does not have any children enrolled and has not had children enrolled since 2019 due to the Covid-19 pandemic. Licensee lives in the home with her husband, Rajiv Puli and their two (2) children, age eleven (11) and eight (8). Licensee’s home was toured for a health and safety inspection. The facility plans to operate from 8:30am – 6:00pm, Monday - Friday.

ON LIMITS AREA: Living Room, First Bedroom on the Right Side of the Hallway, Dining Room, Bathroom Next to Dining Room and Backyard
OFF LIMITS AREA: Master Bedroom and Bathroom, Second Bedroom on the Right, Bedroom in the Corner of the Hallway, Kitchen and Garage
ISOLATION AREA: First Bedroom on the Right

The facility is a single story home owned by the Licensee. The inside of the home was observed to be neat, clean with ample age-appropriate materials for the children. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. Licensee will provide all food for the children. All food that may be brought from the children’s home will be properly labeled and stored. Licensee stated that she will not transport children. There are no pets and no firearms in the home.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2023
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CHINTA, LAKSHMI
FACILITY NUMBER: 013422924
VISIT DATE: 04/18/2023
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There is a fully charged 2A10BC fire extinguisher in the garage. There is one (1) working smoke detector in the on limits bedroom, the dining room and in the hallway. There is one (1) working carbon monoxide detector in the entry way of the hallway. The fireplace in the dining area is blocked and licensee will gate the area. The home is equipped with central heating and air for proper ventilation. The backyard is fully fenced, clean, well maintained with ample age-appropriate materials for the children. Licensee stated that only the cemented area of the backyard will be used for children. The other area will be gated making it inaccessible to the children. There is a shed that will be inaccessible as well. LPA did not observe any harmful bodies of water in or around the home.

Licensee’s Health and Safety training has been completed and Pediatric CPR and First Aid training has expired. Licensee’s Mandated Reporter training is expired as well. LPA informed Licensee that as long she holds an active license, despite not having any children enrolled, these training's must be kept current. All adults living in the home have obtained a criminal record clearance. All required forms will be posted in the living room of the home. Due to no enrollment, there are no files to review.

Licensee was reminded that California Law requires Licensee to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. The Licensee is reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Children’s Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov.
Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting http://www.mandatedreporterca.com.
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: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CHINTA, LAKSHMI
FACILITY NUMBER: 013422924
VISIT DATE: 04/18/2023
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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.

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/process.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Licensee Lakshmi Chinta.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
LIC809 (FAS) - (06/04)
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