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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700489
Report Date: 09/15/2023
Date Signed: 09/15/2023 01:20:57 PM

Document Has Been Signed on 09/15/2023 01:20 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:CHEMALA VENKATA, SINDHUFACILITY NUMBER:
015700489
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/15/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Applicant, Sindhu Chemala VenkataTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Jyoti Saini conducted a scheduled pre-licensing inspection this day, arriving at 10:10 am and met with Applicant Sindhu Chemala Venkata. Applicant lives in the house with her husband, son and minor Daughter. The home is a single-story home consists of 4 bedrooms including Master bedroom and attached bathroom, hallway bathroom, hallway storage closet, living room, dining room, kitchen,family room, backyard, and garage. Per applicant, family childcare’s operating hours will be Monday- Friday, 8:00am -6:00pm.

ON LIMIT AREAS are living room, kitchen, dining room, family room, hallway bathroom and backyard (only cemented part of the backyard)

OFF LIMIT AREAS: all the bedrooms, including master bedroom and bathroom, storage closet in the hallway and garage.

The house appears to be neat and clean with heating and ventilation for safety and comfort. The ISOLATION AREA will be the living room. All off limit areas are properly barricaded. The house has a working smoke and carbon monoxide detector, a working telephone, and a fully charged Fire Extinguisher. There are no pools, hot tubs, or any other bodies of water on the premises. All hazardous materials and toxins are kept out of the reach of children. The kitchen cabinets are latched to prevent children from access. The applicant will be providing snacks and lunch. Applicant states discipline policy is redirection. Per Applicant, she may or may not purchase liability insurance, applicant was advised to use form, the Affidavit regarding liability insurance for FCCH. Parent's Right and the Emergency Disaster Plan were Posted. Applicant were advised to post the License when she received it. Applicant was also advised to conducts fire/disaster drills once every six months, and to log the date and time of the drill. LPA discussed safe sleep guidelines and 15 minutes check requirements.The applicant’s Health and Safety training is completed, and CPR and First Aid certificate are current. There are no wall heaters in the house. The applicant mandated reporter training is complete. Applicant is reminded of NO walker, exersaucers, jumpers, bouncers, and any similar items to be used for children in care and shall be made inaccessible. Smoking is prohibited in family childcare homes. The Applicant is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2023
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CHEMALA VENKATA, SINDHU
FACILITY NUMBER: 015700489
VISIT DATE: 09/15/2023
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Review of records to be maintained LPA reviewed with applicants the LIC 311D, Forms/Records to Keep in Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicants.

APPLICANT OWNS THE HOME:


The applicant provided proof of control of property.

APPLICANT KNOWS PROSPECTIVE CLIENTS WILL NEED IMS:


This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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

Safe Sleep :LPA discussed the safe sleep regulations with applicants 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 [applicant, licensee, or facility representative] 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.

Applicants was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

MyChildCarePlan.org-- Applicants were informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CHEMALA VENKATA, SINDHU
FACILITY NUMBER: 015700489
VISIT DATE: 09/15/2023
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Subscribe to CCLD important information.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Small Family Child Care Home license is recommended effective 09/15/2023.

Exit interview conducted and report was reviewed with the applicant, Sindhu Chemala Venkata.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023
LIC809 (FAS) - (06/04)
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