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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434402075
Report Date: 07/29/2022
Date Signed: 07/29/2022 04:43:29 PM


Document Has Been Signed on 07/29/2022 04:43 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:SUBZWARI, FARZANAFACILITY NUMBER:
434402075
ADMINISTRATOR:SUBZWARI, FARZANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 376-1196
CITY:SAN JOSESTATE: CAZIP CODE:
95124
CAPACITY:14CENSUS: 3DATE:
07/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Farzana SubzwariTIME COMPLETED:
04:55 PM
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Licensing Program Analyst (LPA) James Santos conducted an unannounced Required 1 Year inspection visit at the home today. LPA met with Licensee, Farzana Subzwari and discussed the purpose of today's visit. Present in the home were 3 day care children and the Licensee's mother. Days and hours of operation are Monday - Friday from 6:00am to 6:00pm.

LPA toured the home with the Licensee. The home was observed to be clean and organized. The home has a working telephone service. The License, Notification of Parents’ Rights, Emergency Disaster Plan, and Earthquake Preparedness Checklist were observed to be posted. LPA observed sufficient toys and play equipment for the day care children. Off limit areas inside the home are the kitchen and dining area, living room and and bedrooms. Day care area is located on the side of the home separated by a child gate from the off limits area. Per Licensee, there are no firearms and poisons in the home. All detergents, cleaning compounds and other similar items are inaccessible to children. LPA observed a fire extinguisher, a smoke and carbon monoxide detectors.

The outside backyard area is surrounded by fence. Outside play area was observed to be free of hazards and has sufficient play equipment for daycare childred. There are no bodies of water observed.

LPAs obtained an updated copy of the roster of children in care. Three (3) children's files were reviewed.

Due to time constraints, the annual inspection will be continued on a later date.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G SantosTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2022
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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