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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700197
Report Date: 12/02/2024
Date Signed: 12/02/2024 10:40:19 AM

Document Has Been Signed on 12/02/2024 10:40 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:SHIVASUBRAMANI, UMADEVI & PANDIARAJAN, SUBRAMANIFACILITY NUMBER:
015700197
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 3DATE:
12/02/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:21 AM
MET WITH:Umadevi Shivasubramani and Pandiarajan Subraman- LicenseesTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
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On 12/2/24, Licensing Program Analyst Briana Plumboy, met with licensees Umadevi Shivasubramani and Pandiarajan Subraman for an UNANNOUNCED CASE MANAGEMENT INSPECTION for the purpose of a capacity increase allowing up to 14 children in care while operating within ratio/ the capacity granted. Present for this visit was 3 preschool age children, and fingerprint clear and associated assistant Mahboobha Ahmadi. The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday through Friday from 8:45am until 5:30pm.

On 11/19/24 an approved fire clearance was granted to this facility with comments: "This facility has been approved for daycare use. Only allowed in the living room. No use of any bedrooms or the garage is allowed at anytime."

The ON LIMIT AREAS are the living room, the hallway bathroom, and the backyard ONLY.

All documents have been received for the increase of capacity application. The Licensees were reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

Licensees were reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensees were reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov .

As of 12/2/24, this home is recommended for an increase of capacity. There are no deficiencies cited today. The report will remain on file for three years. A notice of site visit was provided, and the licensee was reminded to have it posted for 30 days. This entire report has been read to the Licensee by LPA Plumboy. The licensee is aware the signature on this report confirm receipt of these documents. LPA asked the licensee if the licensee had any questions pertaining to any aspects including, but not limited to, any part of this report and of the documents given to the licensee, and per licensee, there are no further questions at this time. Licensee is aware at anytime she can reach out to LPA Plumboy or CCLD. An exit interview was conducted, and appeal rights provided.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2024
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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