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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412707
Report Date: 04/29/2025
Date Signed: 04/29/2025 02:13:16 PM

Document Has Been Signed on 04/29/2025 02:13 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 CENTERFACILITY NUMBER:
434412707
ADMINISTRATOR/
DIRECTOR:		JASMIN ANTONYFACILITY TYPE:
850
ADDRESS:525 LOS COCHES STREETTELEPHONE:
(408) 934-1130
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 21DATE:
04/29/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Director Jasmin AntonyTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 4/29/2025 at 10 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required Visit. LPA met with the Director Jasmin Antony, and explained the purpose of today's visit. Present on this visit were 6 staff, 7 toddlers, and 14 preschool children. Facility operates from Monday to Friday 8:00 AM to 6:00 PM.

The facility is licensed for a Preschool Program with Toddler Component. The facility has shared office and storage space with India Community Center. The Licensed Rooms are the Toddler Room and the Preschool Room.

LPA toured the facility with the Director to conduct a Health and Safety Inspection. Facility’s License, Parents’ Rights Poster, Personal Rights, and Activity Schedules were observed to be posted. Facility was observed to follow teacher to children ratio requirement during LPAs' inspection. Children were engaged in various activities under the visual supervision of the teachers.

Classrooms, restrooms and diaper changing area for children to use room were observed to be in safe and sanitary, and in operating conditions. Floor mats or cots are provided for all toddlers. There were no bodies of water observed. Furniture and equipment were in good condition, free of sharp, loose, or pointed parts. The facility prepares and provides meals and snacks for the Toddler Option Program and Preschool Children. Menus are posted. All food were selected, stored, prepared and served in a safe and healthful manner. Trash cans for solid waste had tight-fitting covers on and were in good repair. The food-preparation and storage areas were observed in clean and free of litter and rubbish and the facility have measures taken to keep all such areas free of rodents and other vermin.

Jason JangTELEPHONE: (510) 725-7009
Manel EstoestaTELEPHONE: (510) 622-2602
DATE: 04/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: 04/29/2025
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Floors were clean and safe, and outdoor activity space were free of hazards and there were shaded rest areas for children. Disinfectants, cleaning solutions, poisons, and other items that are dangerous to children were stored inaccessible to children. LPA reminded the Facility Representative that firearms and other weapons are not allowed on or stored on the premises of a child care center.

Outdoor activity space is fenced and was inspected. The play equipment was maintained in a safe condition and free of hazards. There were no bodies of water observed. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were shaded rest areas for children. Drinking water from a non-contaminating fixture or container are readily available both indoors and in the outdoor activity area. The Licensee provides transportation for children and only for other children’s program, not for the Preschool. LPA observed the Motor vehicles used to transport children are maintained in a safe operating condition. LPA observed Smoke and Carbon Monoxide Detectors, fire pull stations, fire extinguishers and sprinkler system. The facility maintains and documenting Fire and Disaster Drills. Facility has a Fire Inspection Permit that expires on 12/31/2025.

Facility files were reviewed. LPA obtained copies of an updated LIC 500 Personnel Report and Facility's Children's Roster. Children and Staff sign in logs were reviewed and LPA obtained copies. Facility is currently using an electronic sign in and out system called "Famly.” A sampling of Children's files was taken for review. The records reviewed include Admission Agreement, Identification and Emergency Information, Medical Assessment, Sleep Logs, and Immunization. A sampling of Staff's files was taken for review. There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection. LPA reminded the Facility Representative that the Mandated Reporter Training requires 2-year renewal requirement. LPA reviewed Staff Immunization records and TB clearance. LPA reminded Facility Representative that only the Influenza vaccination can be decline with a written declination.

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 Facility Representative 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.

SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025
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: 04/29/2025
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

The Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

The Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

There are no deficiencies sited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director Jasmin Antony.

SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025
LIC809 (FAS) - (06/04)
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