<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413410
Report Date: 11/01/2022
Date Signed: 11/01/2022 03:23:19 PM


Document Has Been Signed on 11/01/2022 03:23 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:PATEL, BHARVIFACILITY NUMBER:
434413410
ADMINISTRATOR:PATEL, BHARVIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
4089419871
CITY:SAN JOSESTATE: CAZIP CODE:
95132
CAPACITY:14CENSUS: 11DATE:
11/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Patel BharviTIME COMPLETED:
03:35 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
Page 1
On this 11/1/2022 Licensing Program Analysts (LPA) Stephanie Collin
conducted an unannounced annual random inspection.
LPA met with Licensee, Patel Bharvi and explained the nature of today's inspection. Present during the inspection was the licensee her husband Patel Hiteshkumar and assistant Nilimaben Patel. LPA observed 11 children present .

The hours of operation of the day-care are Monday through Friday 8:00 AM and 5:30 P M. All required posting was posted in a prominent, publicly accessible area at facility. There are 3 adults residing in the home. Licensee 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.

This is a signal family dwelling which consists 4 bedrooms and 2 bathrooms . The home was inspected inside and out. The home was clean and orderly, with heating and ventilation for the safety and comfort of children in care. LPA did not observe flies, other insects, and rodents during the inspection. The observed children’s toys play equipment and materials were in good condition. Furniture and equipment, such tables, chairs, mats, and play pens, they were age appropriate and in good condition. There were no baby walkers observed to be in used. Bathroom used by children was observed to be sanitary and in operating condition. Food preparation area was clean.

Off limit areas in the home are all three bedrooms and master bathroom and living room. There is a Fire Clearance granted for the Family Room and Garage to be used for day care children. The backyard is fenced and is used by children for outdoor activity. There were no bodies of water observed. Licensee stated that there were no weapons such as firearms stored on the premises.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PATEL, BHARVI
FACILITY NUMBER: 434413410
VISIT DATE: 11/01/2022
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
26
27
28
29
30
31
32
Page 2
LPA did not observe any hazards inside of the home or out. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The licensee states that there are no poisons in the home. The licensee does understand that poison must be locked with a key or combination lock.
LPA observed and inspected sleeping equipment for infants. LPA observed Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Each infant has their individual bedding and is washed weekly as required. Soiled bedding is replaced when wet or soiled and is placed in an area inaccessible to infants. Pacifiers were observed to not be attached to anything. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping. Sleep plan was also reviewed.

Facility Records: Licensee and assistant/s have the following: 1. CPR and First Aid, 2. MMR & Tdap vaccinations, 3. A current roster. 4. Licensee is utilizing the affidavit LIC 282 for homeowner’s insurance. 4. Mandated Reporter Training is valid for licensee and assistant both understand this must be renewed every two years.

LPA conducted Children’s Record Review LIC 126, during this inspection. LPA reviewed a percentage of children's files and observed current and updated immunization records and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A), LIC 282 Affidavit, LIC 700 identification and emergency information, LIC 627 Consent for emergency Medical Treatment in each file.

Incidental Medical Services (IMS) policy was discussed. Per Licensee there are currently zero children enrolled who required IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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

SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PATEL, BHARVI
FACILITY NUMBER: 434413410
VISIT DATE: 11/01/2022
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
26
27
28
29
30
31
32
Page 3
LIC 9227 (Individual Sleeping Plan) for infants up to 12 months was review. Title 22 Regulation Section 102425(j) Infant Safe Sleep was discussed with the Licensee, including but not limited to documentation that shall be maintained. A review of PIN 20-24-CCP Recently approved Safe Sleep
LPA discussed the safe sleep regulations with licensee [or facility representative] 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 licensee [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.
Regulations in Effect was discussed, and a copy was provided to the Licensee during this inspection. LPA observed a working smoke/carbon monoxide detector, fully functioning fire extinguisher. The Fire disaster/earthquake drills last log conduct 3/2022.

Supervision of the children was observed; Licensee understands the following: A cleared adult must be present in the home during day care hours. The children must be supervised at all times. The capacity options and ratio requirements must be observed. Licensee understands not to leave children in the car unattended. The Licensee states that there is no transporting of children currently.
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.

At this time, there were no deficiencies cited during today’s inspection.

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



Exit interview conducted and report was reviewed Licensee
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3