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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500926
Report Date: 12/04/2024
Date Signed: 12/04/2024 01:45:22 PM

Document Has Been Signed on 12/04/2024 01:45 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KALIAPPAN, MAHESHWARIFACILITY NUMBER:
394500926
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 2DATE:
12/04/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Maheshwari KaliappanTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 12/04/2024, Licensing Program Analyst (LPA) Corina Beckby conducted a Case Management visit for the purpose of increasing the licensed capacity from 8 to 14 children. LPA met with Licensee, Maheshwari Kaliappan. Fire Safety Inspection Clearance was granted by South County Fire Authority Community Risk Reduction on 11/27/2024 for a total capacity of 14 children. Facility hours of operation are Monday - Friday from 07:00 am to 6:00 pm. All individuals subject to criminal background review have obtained a criminal record clearance. LPA observed Licensee caring for 2 daycare child including 1 infant.

A health and safety inspection was conducted in all areas accessible to children. Home appears orderly and suitable for children. OFF-limits are the garages, 2nd floor, laundry room, walk in pantry, storage closet, and un-landscaped backyard. Hazardous items were stored inaccessible to children. Napping equipment and age-appropriate toys were observed. Licensee stated there are no weapons in the home. Home has a working telephone, a 2A10BC fire extinguisher and dual functioning smoke and carbon monoxide detector. LPA observed stairs properly barricaded. The backyard is fenced for supervision. Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.



Current CPR & First Aid was verified and expires on 05/06/2025. Mandated reporter certificate expires on 12/4/2026. LPA reviewed large family childcare home capacity limitations with licensee.

Continued on 809-C...

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: KALIAPPAN, MAHESHWARI
FACILITY NUMBER: 394500926
VISIT DATE: 12/04/2024
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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 platform. 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.

Licensee 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, 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.

Capacity increase is approved as of today, 12/04/2024. The facility is licensed to serve a MAX. CAP (WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6. LICENSEE UNDERSTANDS THAT WHEN ASSISTANT IS NOT PRESENT, THE CAPACITY REVERTS TO A SMALL FAMILY CHILD CARE HOME.



An exit interview was conducted, and the report was reviewed with Maheshwari Kaliappan, to keep on file at the facility. License Appeal Rights were provided. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

No deficiencies were cited during today’s visit.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
LIC809 (FAS) - (06/04)
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