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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416284
Report Date: 08/24/2023
Date Signed: 08/24/2023 03:17:07 PM

Document Has Been Signed on 08/24/2023 03:17 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:VIDYARAMBHFACILITY NUMBER:
434416284
ADMINISTRATOR:LATHA KALIMANIFACILITY TYPE:
830
ADDRESS:20015 STEVENS CREEK BOULEVARDTELEPHONE:
(408) 444-5019
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY: 12TOTAL ENROLLED CHILDREN: 11CENSUS: 8DATE:
08/24/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Latha KalimaniTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Marilou Monico conducted a Case Management inspection in response to an unusual incident that was received by Licensing on August 18, 2023. The incident occurred on August 14, 2023 involving a daycare child (C-1) who sustained an injury while in care. LPA toured the facility, interviewed staff, reviewed staff file, and obtained copy of children's roster and sign in/out sheet.

Based on interviews and evidence gathered, there is no preponderance of evidence to prove that staff violated a child's personal rights or there was lack of supervision.

As a result of this inspection, there were no deficiencies cited.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2023
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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