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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423061
Report Date: 02/09/2023
Date Signed: 02/09/2023 03:23:02 PM

Document Has Been Signed on 02/09/2023 03:23 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 MONTESSORIFACILITY NUMBER:
013423061
ADMINISTRATOR:AMBERKER, KSHAMA N.FACILITY TYPE:
850
ADDRESS:38660 LEXINGTON ST.TELEPHONE:
(510) 396-2403
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 61TOTAL ENROLLED CHILDREN: 50CENSUS: 46DATE:
02/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Kshama AmberkerTIME COMPLETED:
12:30 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 February 9, 2023 at approximately 8:45am, LPA Haderer began the unannounced for an annual inspection for compliance to Health and Safety. Present for the inspection was the site director Kshama Amberker, 6 teachers and 46 children in care. The facility is in ratio today.

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 years old; Room 2 is used for 3 – 4 ½ years old; Room 3 is currently used for 4 – 5 ½ years old. 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 in the building.



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. A child sandbox in the preschool playground area had a large sand-filled play tractor toy with accumulated rainwater that was not removed after the recent rains. This is a Type A deficiency, see LIC809D.
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.

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 3-29-2022. Fremont Fire Department conducts fire inspections. Carbon monoxide and smoke detectors were available, tested and functioning. Disaster drills are conducted monthly, the last drill was conducted 12-15-2022.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2023
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 5
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: 02/09/2023
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
26
27
28
29
30
31
32
The facility is clean and well organized with ample age appropriate furnishings and equipment. Heating and ventilation in the classroom is acceptable. Surfaces including floors and counter tops are clean and toxic free. The facility provides snacks and lunch for the children, menus were appropriately posted in each classroom. Food is prepared for children on site. Kitchen area was inspected and found to be clean and safe. All stored foods for children were checked and everything was within expire date, and non-fat milk available to be served to children.

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. One new staff member did not have their Mandated Reporter completed – see LIC809D for deficiency.

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.

Licensee 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.

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: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: 02/09/2023
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
26
27
28
29
30
31
32
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 were 2 deficiencies issued this day, one Type A and one Type B:

One Type A for standing rainwater that accumulated in the children’s sandbox in the playground area and was holding water. This deficiency must be posted at the facility for 30 days. The licensee was cited for the $500 civil penalty and must distribute a copy of the Type A deficiency to all current parents of children in care and they must return the licensing form acknowledging receipt. For the next one-year period, all parents of newly enrolled children must receive a copy of the deficiency and return the licensing form acknowledging receipt. All these signed acknowledgement forms must be kept in the children’s files for licensing review.

Type B - One new staff member did not have their Mandated Reporter completed

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



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: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 02/09/2023 03:23 PM - It Cannot Be Edited


Created By: Russell Haderer On 02/09/2023 at 01:29 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: 02/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101238(e)
Buildings and Grounds
(e) All licensees shall ensure the inaccessibility of pools, including swimming pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds or similar bodies of water, through a pool cover or by surrounding the pool with a fence.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that a child sandbox in the preschool playground area had a large sand-filled play tractor toy with accumulated rainwater that was not removed after the recent rains which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/09/2023
Plan of Correction
1
2
3
4
Licensee immediately removed the water from the tractor sandbox toy and removed the toy from the playground area.
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: 02/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2023


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 02/09/2023 03:23 PM - It Cannot Be Edited


Created By: Russell Haderer On 02/09/2023 at 01:29 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: 02/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in that one new staff member did not have their Mandated Reporter completed (Child Care Provider AB1207) which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/13/2023
Plan of Correction
1
2
3
4
Licensee to ensure new staff member takes the Mandated Reporter training at www.mandatedreporterca.com , Child Care Provider (AB1207) and submits a completion certificate to LPA as proof of compliance. Going forward, all new staff must complete this training before their start date and renew the certificate every two years.
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: 02/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2023


LIC809 (FAS) - (06/04)
Page: 5 of 5