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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408619
Report Date: 02/04/2025
Date Signed: 02/04/2025 11:56:35 AM

Document Has Been Signed on 02/04/2025 11:56 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:BEHERA, SANJUKTAFACILITY NUMBER:
073408619
ADMINISTRATOR/
DIRECTOR:
BEHERA, SANJUKTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 757-1655
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 9DATE:
02/04/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:48 AM
MET WITH:Sanjukta BeheraTIME VISIT/
INSPECTION COMPLETED:
11:55 AM
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On 2/4/2025 at 9:48am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Sanjukta Behera for an announced annual/random inspection. Present during the inspection was the Licensee, her minor helper, one (1) infant and seven (7) preschool age children. One (1) additional preschool age child arrived at 10:42am. Licensee’s husband was present working in the home but remained upstairs in an off-limit area. Licensee lives in the home with her husband and their minor son. Licensee’s home was toured for a health and safety inspection. The facility operates 8:00am – 5:30pm, Monday – Friday.

ON LIMITS AREA: Entire 1st Floor (Living Room, Kitchen, Dining Area, Downstairs Bathroom, Downstairs Bedroom) and Backyard
OFF LIMITS AREA: Entire 2nd Floor and Garage
ISOLATION AREA: Living Room

The facility is a two-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’s learning and play. All toxins, cleaning products, personal medications, and hazardous materials were observed to be in inaccessible areas. Licensee provides all meals and snacks for the children and all food that is brought from the children’s home is properly labeled and stored. Licensee uses high chairs, feeding tables and child sized tables for meal times that were observed to be in good repair and free of defects. Licensee provides cots for the children and all napping materials were observed to be clean and properly stored. All diapering materials were observed to be properly stored and labeled. All off-limit areas in the home are made inaccessible with locks and gates. Licensee stated she does not transport children, there are no firearms and there are no pets in the home.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2025
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: BEHERA, SANJUKTA
FACILITY NUMBER: 073408619
VISIT DATE: 02/04/2025
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LPA observed an infant rocker in the living room and informed Licensee that rockers are not allowed in care. LPA instructed Licensee that it needed to be removed from the on-limit areas of the home to prevent any children from using it while in care.

LPA observed one (1) fully charged 2A10BC fire extinguisher in the closet next to the garage door. There is one (1) working smoke detector in front of the downstairs bedroom, in the living room, and inside the downstairs bedroom. There is a working carbon monoxide detector on the kitchen counter. The stairs leading to the second floor of the home is gated at the bottom of the staircase making it and the second floor inaccessible to the children in care. The backyard is fully fenced with ample age-appropriate materials for the children. LPA did not observe any harmful bodies of water in or around the home. There are no pools or jacuzzis at the home.

The facility is operating within its licensed capacity and is in ratio. Licensee’s Health and Safety training has been completed and EMSA approved Pediatric CPR & First Aid training is complete and expires 9/30/2025. Licensee’s Mandated Reporter training is complete and expires 9/18/2025. Fire/disaster drills have been conducted and documented, with the last drill logged on 8/5/2024. LPA verified all adults living and working in the home have obtained a criminal record clearance. All required forms are currently posted by the front door of the home. LPA obtained a sample of the children’s files, and facility files. All files were complete.

No deficiencies cited during LPAs inspection.

Licensee was reminded that California law requires Licensees to report unusual incidents and/or injuries to children in care, to the child's authorized representatives, and to Community Care Licensing Division (CCLD) within 24 hours by phone. Within seven (7) days of the incident, Licensees must submit the Unusual Incident/Injury form (LIC 624B) to CCLD. Licensee was reminded that any structural changes or additions to the home must be reported to CCLD. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
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: BEHERA, SANJUKTA
FACILITY NUMBER: 073408619
VISIT DATE: 02/04/2025
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Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting mandatedreporterca.com/. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, Licensee Sanjukta Behera, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.




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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
LIC809 (FAS) - (06/04)
Page: 3 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: BEHERA, SANJUKTA
FACILITY NUMBER: 073408619
VISIT DATE: 02/04/2025
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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.

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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

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 the Licensee Sanjukta Behera.




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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
LIC809 (FAS) - (06/04)
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