434413644-9-22-2022-07-CC-PHEZ-CJHRN3-20220922130939

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413644
Report Date: 09/22/2022
Date Signed: 09/22/2022 01:09:49 PM

Document Has Been Signed on 09/22/2022 01:09 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, AARTI VIBHESH		FACILITY NUMBER:	434413644
ADMINISTRATOR:	PATEL, AARTI VIBHESH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 425-6110
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95129
CAPACITY:	14	CENSUS: 10	DATE:	09/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Aarti Patel		TIME COMPLETED:	01:25 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	Licensing Program Analyst (LPA) Pete Hernandez conducted an unannounced Required 1 Year Inspection at the home today. LPA met with Aarti Patel, Licensee, and explained the nature of today's visit to her. Also present today was licensee's helper Aarti's mother Chandrikab Patel. There were 6 day care children present at the time of LPA’s arrival. Hours are Monday - Sunday from 6:00 AM to 11:00 PM. The Licensee states, spouse, Vibhesh Patel lives in the home along with Aarti's Mother in Law Chandrika Patel and live in the home. Also present is Helper Andrea Lugo. LPA observed 10 children: 3 infants and 7 Preschoolers. LPA toured the indoor or and outdoor areas of the home. Fire drills are conducted every 6 months and logged. Last entry was 5/1/22. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is orderly, and safe for the day care children. Off limit areas in the home are the master bedroom and bathroom, 3 Bedrooms, garage, laundry room. On limit areas; Living room, kitchen, dining room, family room, back room addition, and entire back yard. LPA observed 1 fully charged 3A40BC fire extinguisher. There are working smoke & carbon monoxide detectors and fire pull stations in the home. LPA observed a fenced backyard and a hot tub that is covered and locked. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, other similar items and poisons are in the bedroom and in cupboard out of reach of children and are inaccessible to children. LPA reviewed the files of 10 enrolled children and 2 Staff files, all the files have all of the required documentation and immunizations. ( Exept 3 infants were missing LIC9227 forms) REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 9/22/2022

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

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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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, AARTI VIBHESH	FACILITY NUMBER: 434413644
	VISIT DATE: 09/22/2022

NARRATIVE

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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

A review of staff records today indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12- month period. Civil penalties are cited today.
Supervision of children was discussed with the Licensee. Licensee understands that she must be present in the home at least 80 percent of the hours the day care is in operation and ensure that the children are supervised at all times. The Licensee understands her capacity options. The Licensee states that she does not transport children and understands that children cannot be left in parked vehicles unattended at any time. Licensee understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick child, requirements for reporting suspected child abuse, unusual incidents/injuries, heat-related illnesses, and requirements for assistant/substitute were also discussed.

LPA informed Licensee that Licensing forms and Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov

LPA discussed with and provided for LIC9227 the Licensee as it pertains to the infant care requirements.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3 - REPORT DATED 09/22/2022

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PATEL, AARTI VIBHESH	FACILITY NUMBER: 434413644
	VISIT DATE: 09/22/2022

NARRATIVE

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Licensee's CPR and First Aid Expire on 2/13/2024.

LPA discussed the Individual Infant Plan LIC9227 with the licensee.

LPA reminded the Licensee that the converted garage was not approved for use by the fire department inspection and should not be used for children at any time.

Type A language: Upon the issuance of Type A citations, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

A deficiency is being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted with the licensee. A copy of this report and appeals rights were discussed and left with the Licensee, Aarti Patel, whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/22/2022 01:09 PM - It Cannot Be Edited

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, AARTI VIBHESH	FACILITY NUMBER: 434413644
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/22/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Per LPA's review of files, Helper doe not have Mandated Reporter Training per AB1207. This poses a potential risk to the health and safety of children in care.
	POC Due Date: 11/03/2022
	Plan of Correction
1 2 3 4	BY POC DUE DATE: 11/3/2022 Assistant Provider will complete the training and send a copy of the Certificate of Completion to Licensing Office. LPA provided the web address https://www.mandatedreporterca.com to access the required training.

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	LPA reviewed the files of infant children identified as C1, C2 and C3 and there were not any LIC9227 Individual Infant Sleeping Plans in their respective files which poses/posed a potential health, safety or personal rights risk to persons in care. C-2 and C3 are already over 12 months at this time.
	POC Due Date: 09/28/2022
	Plan of Correction
1 2 3 4	BY POC DUE DATE; the Licensee shall provide copy of the completed LIC9227 forms for the C1 whom is under 12 months of age and a written plan of correction describing how she will insure they will be completed in the future.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

LIC809 (FAS) - (06/04)

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