434412707-3-22-2023-52-CC-MESA-CQ6S8X-20230322133952

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412707
Report Date: 03/22/2023
Date Signed: 03/22/2023 01:40:06 PM

Document Has Been Signed on 03/22/2023 01:40 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	INDIA COMMUNITY CENTER		FACILITY NUMBER:	434412707
ADMINISTRATOR:	JASMIN ANTONY		FACILITY TYPE:	850
ADDRESS:	525 LOS COCHES STREET		TELEPHONE:	(408) 934-1130
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	36	CENSUS: 19	DATE:	03/22/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:29 AM
MET WITH:	Kilma Desai and Jasmin Antony		TIME COMPLETED:	02:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On Wednesday, March 22, 2023, Licensing Program Analyst (LPA) Manel Estoesta conducted an Unannounced Required One (1) Year Visit. LPA met with the Site Supervisor Klima Desai and the Director Jasmin Antony and explained the nature of the site visit. Present on this visit were 5 toddlers, 14 preschool children and 6 staff members. Facility operates from Monday through Friday from 8:30 AM - 5:30 0PM. This facility is located inside the India Community Center Building. The License is a Preschool Program with Toddler Component. The facility has shared office space, storage space and any other general-purpose space with the India Community Center Building. LPA toured the facility to conduct a health and safety inspection with the Director. The childcare center is clean, safe, sanitary and in good repair. The toddler program is conducted in Room 1 physically separate from those used by older children. The Preschool Program is conducted in Room 2 and 3. At 10 am to 11 am, LPA observed the following. 1. 5 toddlers in Room 1 with 4 staff members. 14 preschool children in Room 2 with 2 staff members. 2. Furniture and equipment such as but not limited mats, chairs and changing table were in sanitary, safe, and functioning condition, free of sharp, loose, or pointed parts. 3. There were no bodies of water. 4. Director stated that facility does not possess nor store any weapons on the premises. 5. Disinfectants, cleaning solutions, sharps, and other items that are dangerous to children were stored inaccessible. 6. Toddler changing tables were located within arm’s reach of a sink. 7. Menus were posted. The facility offers AM and PM snacks, and lunch for the Toddler Component only. SEE 809 C.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: INDIA COMMUNITY CENTER	FACILITY NUMBER: 434412707
	VISIT DATE: 03/22/2023

NARRATIVE

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Continuation.

8. There were no baby walkers observed.
9. Indoor activity space is equipped with a variety of age-appropriate washable toys and equipment.
10. LPA observed that drinking bottles and containers of food brought into the facility by the children authorized representative were individually labeled with the children's name and current date.
11. LPA observed a fire extinguisher, Emergency Bag that has a First Aid Kit, Fire Pull Alarm, smoke, and carbon monoxide detectors.

At noon, LPA reviewed the following.
1. Fire Drill was last conducted on 03/02/2023
2. Earthquake Drill was last conducted on 03/23/2023
3. Paper Sign in and Out Sheets (children).
4. Facility files were reviewed. Child sign in and out procedures, LPA also obtained copies of the Facility's updated Personnel Report and Child Care Facility Roster.
5. Staff files were reviewed.
6. Children Files were reviewed. Each child’s file contains but not limited to, which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Risks, Effects of Lead Poisoning PUB 515 and Immunization, Needs and Services Plan (Infant Feeding and Toilet Training) and Napping / Sleep Log.
7. Daily Activity Schedule.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SEE 809 C....

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: INDIA COMMUNITY CENTER	FACILITY NUMBER: 434412707
	VISIT DATE: 03/22/2023

NARRATIVE

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Continuation.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

For licensing updates, please email childcareadvocatesprogram@dss.ca.gov and request to be added to the email list. Previous Provider Information Notices (PINs) - Child Care Licensing Program (CCLP) are available at the CCLD website and other helpful information at https://cdss.ca.gov/inforesources/child-care-licensing.

A notice of site visit was given and must remain posted for 30 days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

LPA discussed to the Director the PIN 20-24-CCP RECENTLY APPROVED SAFE SLEEP REGULATIONS IN EFFECT, Lead Testing and Prevention Information in Accordance with AB 2370, Chapter 676, Statutes of 2018, American Rescue Plan Act Survey and Child Care and Development Infrastructure Grant Program

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

There are no deficiencies cited on this visit.

Exit interview conducted and report was reviewed with the Director Jasmin Antony.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC809 (FAS) - (06/04)

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