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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101501
Report Date: 07/10/2024
Date Signed: 07/10/2024 01:41:51 PM

Document Has Been Signed on 07/10/2024 01:41 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ARUMUGAM, ANNALAKSHMI FCCFACILITY NUMBER:
376101501
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 12CENSUS: 6DATE:
07/10/2024
TYPE OF VISIT:Annual/RandomANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Annalakshmi ArumugamTIME VISIT/
INSPECTION COMPLETED:
01:45 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 7/10/24 at 11:15 a.m., Licensing Program Analyst (LPA), Renita Rodriguez, conducted an announced Prelicensing Inspection/ capacity change. Licensee was due for annual inspection. Annual inspection completed on this day. LPA was greeted at the front door by, Annalakshmi Arumugam. LPA was granted entry after showing badge and identifying herself and disclosing the purpose of her visit. There were 6 children in care present which included 2 infants. Helper Jaberlin Wilson was present in the home. The 2 bedroom, 1 loft and 2 bathroom home was toured and inspected for compliance. Licensee is using the following areas for daycare: living room, bedroom 1, kitchen, and bathroom 1. Bedroom 2, bathroom 2, loft, and garage is off limits. The home has stairs at entrance leading up to the loft and down to the area used for day care. The stairs are secured by security gate. The children are provided a safe, healthful, and comfortable environment, furnishings, and equipment. Licensee owns the home. Annalakshmi Arumugam provided proof of control of property. Licensee states that they have sufficient financial resources to sustain the license.

LPA tested the smoke alarm and carbon monoxide detector, which is operational. There is a fire extinguisher size 2A10BC in the kitchen that meets regulations. LPA did not observe a swimming pool. Licensee states there are no bodies of water at the home and LPA did not observe any. Licensee stated there are no weapons or ammunition stored on the premises and LPA did not observe any.

There is a fireplace located in the living room which is secured, locked and inaccessible to children in care. Storage for poisons, detergents, cleaning solutions, medications are out of reach, in off limit areas, and inaccessible to children by latches and locks. There are sufficient toys and equipment available. Outdoor play area will take place in licensee fenced back yard. Licensee is reminded constant supervision is required. The home is kept clean and orderly with heating and ventilation for safety and comfort. Pediatric CPR and First Aid card will expire 3/11/25. Mandated Reporter Training was completed 3/8/23. Applicant is using cell phone to meet requirements. Required documents are posted. Children and Staff records were reviewed and found to be in order.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ARUMUGAM, ANNALAKSHMI FCC
FACILITY NUMBER: 376101501
VISIT DATE: 07/10/2024
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
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-andresources/safe-sleep as an additional resource. LPA also informed 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.

Licensee/applicant 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.

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

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.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ARUMUGAM, ANNALAKSHMI FCC
FACILITY NUMBER: 376101501
VISIT DATE: 07/10/2024
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 approval for the capacity change will be completed upon final file review.

Exit interview conducted and report was reviewed with the licensee/applicant Annalakshmi Arumugam.

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

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

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3