013423061-3-3-2022-52-CC-RHAR-CC6ULG-20220303144044

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423061
Report Date: 03/03/2022
Date Signed: 03/03/2022 02:40:58 PM

Document Has Been Signed on 03/03/2022 02:40 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:	AMBA BHAVANI LLC/DBA KEEN LEARNERS MONTESSORI		FACILITY NUMBER:	013423061
ADMINISTRATOR:	AMBERKER, KSHAMA N.		FACILITY TYPE:	850
ADDRESS:	38660 LEXINGTON ST.		TELEPHONE:	(510) 396-2403
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY: 61	TOTAL ENROLLED CHILDREN: 39	CENSUS: 37	DATE:	03/03/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:05 AM
MET WITH:	Kshama Amberker		TIME COMPLETED:	01:00 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 March 3, 2022 at approximately 8:05am, LPA Haderer arrived unannounced for an annual inspection for compliance to Health and Safety. The new CARE tool was used for the inspection. Present for the inspection was the site director Kshama Amberker, 5 teachers and 37 children in care. The facility is in ratio. The facility has two license numbers, pre-school is on the ground floor, school age is upstairs. For the pre-school on the ground floor there are 3 classrooms, numbered 1 through 3. Room 1 is currently used for 2 – 3 ½ year olds; Room 2 is currently used for 3 – 4 ½ year olds; Room 3 is currently used for 4 – 5 ½ year olds. Children’s bathrooms are available in the classrooms, there are enough towels and soap supplies. Sinks do not use hot water, only cold water is available. The staff have separate adult bathroom located on campus. The children have their own fenced outdoor playground area and playground equipment. There is a waiver issued that requires that children alternate their time in the playground to meet space requirements (square footage per child indoor/outdoor space). LPA observed that all playground structures and toys are in safe condition and free from sharp, loose or pointed parts. The areas around or under high climbing equipment and slides have appropriate cushioned material that absorbs a fall. There is ample shade provided by large trees. Sign in/out sheets are done electronically. All children present were signed in, however, it was found that two additional children had been logged in by a parent causing the count not to match. This is a Type B deficiency, see LIC809D. All children’s bathroom sinks had sufficient hand soap and paper towels. Children bring in bottled water and each classroom also has a water fountain and jugs of water with paper cups. All classroom had trash cans with tight fitting lids. First aid kits were available in each classroom and in the outside playground area.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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: AMBA BHAVANI LLC/DBA KEEN LEARNERS MONTESSORI	FACILITY NUMBER: 013423061
	VISIT DATE: 03/03/2022

NARRATIVE

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The facility has fully charged fire extinguishers in the building. There is a 3A40BC fire extinguisher in first floor hallway and upstairs there is a 4A80BC. The last annual inspection was done on both on 4/14/2021. Fremont Fire Department conducts fire inspections. Carbon monoxide and smoke detectors were available, tested and functioning. Heating and ventilation in the classroom is acceptable. Disaster drills are conducted monthly, the last drill was conducted 3-2-2022.

The facility is clean and well organized with ample age appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. The school follows proper Covid-19 protocols, parents and visitors are not allowed, children and staff are all wearing face coverings. Hazardous items/toxins are kept out of the access of children. There are no bodies of water accessible to children in care. The facility provides snacks and lunch for the children, menus were appropriately posted in each classroom.

At 11:05am staff files were reviewed. Opening and closing staff have current CPR and first aid training. All staff subjected to criminal review have been cleared and associated to the facility.

At 12:30pm, children's records were reviewed: LPA requested and reviewed facility roster, a copy was taken for the office file. All files were well organized and complete.

All documents required to be posted were appropriately posted on the walls: License; Emergency Disaster Plan; Earthquake Preparedness checklist; Notification of Parents Rights; Personal rights; Child seatbelt laws; menus; daily activity schedules.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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: 03/03/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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: AMBA BHAVANI LLC/DBA KEEN LEARNERS MONTESSORI	FACILITY NUMBER: 013423061
	VISIT DATE: 03/03/2022

NARRATIVE

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Site Director was reminded that all adults 18 and over, 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 Child Care Center. 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.

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 was 1 Type B deficiency issued this day, see LIC809D. This report will remain on file for 3 years.

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

Annual inspection for this license component was completed at 1:00pm.

Exit interview conducted and report was reviewed with the Site Director Kshama Amberker.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/03/2022 02:40 PM - It Cannot Be Edited

Created By: Russell Haderer On 03/03/2022 at 12:55 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: AMBA BHAVANI LLC/DBA KEEN LEARNERS MONTESSORI	FACILITY NUMBER: 013423061
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101229.1(b)

Sign In and Sign Out

(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in that a parent signing in their child signed in two additional children (family members) and it caused the count of present children to be off by two which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/10/2022
	Plan of Correction
1 2 3 4	Staff will contact parents and inform them to be certain they only sign in children that they drop off at the school. Center Director will hold a staff meeting and require staff to monitor this at the door to ensure parents only sign in the correct child being dropped off so the student count matches the signed-in count. As proof of correction, center director will provide the LPA copy of email sent to parents and staff meeting agenda and staff sign notes showing date of meeting.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Chandra Charles

LICENSING EVALUATOR NAME:

Russell Haderer

LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

LIC809 (FAS) - (06/04)

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