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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400386
Report Date: 02/19/2025
Date Signed: 02/19/2025 10:52:59 AM

Document Has Been Signed on 02/19/2025 10:52 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:CASA DEI BAMBINI SCHOOLFACILITY NUMBER:
434400386
ADMINISTRATOR/
DIRECTOR:		ROSHAN A. & SANDRA B.FACILITY TYPE:
850
ADDRESS:463 COLLEGE AVENUETELEPHONE:
(650) 473-9401
CITY:PALO ALTOSTATE: CAZIP CODE:
94306
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 0DATE:
02/19/2025
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Roshan Amerasinghe & Sandra BalzarettiTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
NARRATIVE
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On 02/19/2025 at 10:00am, Licensing Program Analyst (LPA) Jialing “Julianne” Zhu and Licensing Program Manager (LPM) Chandra Charles met with Licensee Sandra Balzaretti and Director Roshan Amerasinghe for a scheduled informal office meeting at the Oakland Southeast Regional Office. The purpose of the meeting is to discuss the deficiency cited on 02/06/2025 during the annual inspection.

During the meeting, the requirements for recordkeeping were discussed, with a focus on Mandated Reporter training certificates and EMSA-approved Pediatric CPR/First Aid training. During the annual inspection on 02/06/2025, LPA observed Director’s paper Mandated Reporter Certificate has the Director’s name, but the QR code on the certificate links to another Casa Dei Bambini staff’s digital certificate. The date of completion on the paper certificate also did not match the date on the digital certificate. This finding is considered to be conduct inimical. Therefore, a Type A deficiency was cited during today’s office visit. See LIC 809D for details.

As a result of the Type A deficiency cited during today’s meeting, a copy of this report and LIC 9224 Acknowledgment of Receipt of Licensing Reports must be provided to parents/guardians of current enrolled children in care and all children enrolled following a 12-month period of this report. The LIC 9224 must be signed within the next business day the children are in care and is to be kept in the children’s files.

Exit interview was conducted, report was reviewed, and Appeal Rights were provided to Licensee Sandra Balzaretti and Director Roshan Amerasinghe.

Page 1 of 1. End of Report.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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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Document Has Been Signed on 02/19/2025 10:52 AM - It Cannot Be Edited


Created By: Jialing Zhu On 02/19/2025 at 10:20 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CASA DEI BAMBINI SCHOOL
FACILITY NUMBER: 434400386

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/19/2025
Section Cited
HSC
1596.885(c)

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(c) Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state.

This requirement is not met as evidence by:
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Director will submit written statement of understanding regarding recordkeeping to ensure Mandated Reporter certificates of all staff are up to date and belongs to the staff.
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Based on observation, interview, and record review, the licensee did not comply with the section cited above as director's Mandated Reporter certificate did not belong to her, which poses an immediate health, safety, and/or personal rights risk to persons in care.
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The statement will also address Pediatric CPR/First Aid to ensure the training completed by staff is EMSA-approved. Director will email written statement to LPA via email at jialing.zhu@dss.ca.gov by 02/20/2025.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Chandra Charles
LICENSING EVALUATOR NAME:Jialing Zhu
LICENSING EVALUATOR SIGNATURE:
DATE: 02/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/19/2025


LIC809 (FAS) - (06/04)
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