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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500519
Report Date: 11/09/2023
Date Signed: 11/09/2023 02:07:26 PM

Document Has Been Signed on 11/09/2023 02:07 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:NAMBI, RAJALAKSHMIFACILITY NUMBER:
394500519
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
11/09/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:34 PM
MET WITH:Rajalakshmi NambiTIME COMPLETED:
02:40 PM
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On November 9, 2023, Licensing Program Analyst (LPA) Stacey Williams met with Licensee, Rajalakshmi Nambi for the purpose a case management inspection to increase capacity of licensure. Licensee requested a capacity increase to 14 children. LPA and Licensee toured the two story 3-bedroom home. Off-limit areas include: entire upstairs, kitchen, and the garage. Licensee acknowledged that children may never enter these off-limit areas. Licensee stated there are no new residents in the home since licensure. All Adult residents have criminal record clearances. LPA observed three preschool aged children supervised by Licensee and her Assistant.

LPA observed cleaning supplies properly stored out of reach of children. LPA observed medications out of reach of children. Licensee stated there are no weapons in the home. Fire extinguisher (2A10BC), smoke detector, and carbon monoxide detector meet regulatory standards. Toys appear to be clean and safe. The stairs have a security gate attached.

Licensee utilizes the right side of the front patio area for children to play. Licensee stated that she provides 100 percent supervision while the children are outside.

Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.

LPA reviewed Licensee and staff files during today’s inspection. LPA observed current CPR/First Aid certificate for Licensee with an expiration date of 11/2024. Child files were also reviewed and found to contain required licensing documents. during today's inspection. LPA observed the file contained emergency contact information and signed Notifications of Parents’ Rights.

Community Care Licensing Sacramento South (Childcare Program) received a Fire Safety Inspection Clearance and the home has been cleared for up to 14 children.
Fire clearance has been approved by the French Camp – McKinley Rural FPD. Large family childcare home capacity limitations were reviewed during today's inspection.

Report Continues on LIC 809-C

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2023
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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: NAMBI, RAJALAKSHMI
FACILITY NUMBER: 394500519
VISIT DATE: 11/09/2023
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All adults subject to criminal background review have obtained criminal record clearance. Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs 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. LPAs discussed the requirement to check and log infant napping every 15 minutes, for infants under 24 months and under 24 months. LPAs provided a copy of LIC 9227 Individual Sleeping Plan, for infants under 12 months.

IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

Licensee 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.

Effective 11/9/23, Licensee, Rajalakshmi Nambi is approved for the capacity increase to serve up to either 14 children, one (1) of which must be enrolled in kindergarten and at least one (1) 6 years of age and no more than three (3) may be infants; or 12 children, four (4) of which may be infants. Infants are children under the age of 2.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023
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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: NAMBI, RAJALAKSHMI
FACILITY NUMBER: 394500519
VISIT DATE: 11/09/2023
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In the areas that were evaluated, no deficiencies were observed at the time of the inspection.

LPA reviewed report with the Licensee, Rajalakshmi Nambi and provided copies of the report along with Appeal Rights. A notice of site visit was provided and posted by LPA Williams and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023
LIC809 (FAS) - (06/04)
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