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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409785
Report Date: 03/12/2024
Date Signed: 03/12/2024 09:10:58 PM


Document Has Been Signed on 03/12/2024 09:10 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:SAINI, JASVINDERFACILITY NUMBER:
434409785
ADMINISTRATOR:SAINI, JASVINDERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 394-0904
CITY:SAN JOSESTATE: CAZIP CODE:
95133
CAPACITY:14CENSUS: 7DATE:
03/12/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Jasvinder SainiTIME COMPLETED:
04:00 PM
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On 3/12/24 Licensing Program Analyst (LPA) Sheena Chin conducted an unannounced Case Management – deficiencies inspection at the facility and met with the licensee, Jasvinder Saini. Present were the licensee, a helper and 7 children in the facility.

On 11/21/23 LPA Sheena Chin conducted an unannounced annual inspection at the facility and 9 deficiencies were cited. The licensee sent LPA copies of correction proofs in January and February 2024 but there were two deficiencies, parents’ rights poster posted and children’s immunization records, that the licensee was not able to send proofs of corrections.

During today’s inspection a signed individual parent’s right form was posted but a parents’ rights poster was not observed. The licensee stated that she did not understand the parents’ rights poster even though LPA send the licensee the poster via email. The licensee stated that she thought it’s good enough to post a signed individual parent’s right form. LPA printed out the parents’ rights poster and the licensee posted it on a prominent location.

Children’s immunization records were observed.

No regulatory violations were observed during the inspection.

Exit interview was conducted and report was reviewed with Jasvinder Saini. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Sheena ChinTELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2024
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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