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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413644
Report Date: 04/18/2024
Date Signed: 04/18/2024 05:10:02 PM

Document Has Been Signed on 04/18/2024 05:10 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:PATEL, AARTI VIBHESHFACILITY NUMBER:
434413644
ADMINISTRATOR/
DIRECTOR:		PATEL, AARTI VIBHESHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 425-6110
CITY:SAN JOSESTATE: CAZIP CODE:
95129
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
04/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:12 PM
MET WITH:Aarti Vibhesh PatelTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Annual/Random inspection. LPA met with Licensee Aarti Vibhesh Patel and explained the reason for the inspection. Present during today's inspection were Licensee, her mother, her mother-in-law, her minor child, and nine (9) children, whom four (4) were infant age. Her mother and mother-in-law also help with the family child care home (FCCH). One additional assistant arrived shortly after.

Postings, such as license and notification of parent's rights, are located in the converted garage. The hours of operation are Monday through Sunday 7AM to 8PM. Licensee does not have liability insurance and does own the home. Licensee will submit proof of property.

LPA toured the inside and outside area of the home with Licensee. The off-limit areas of the home are the master bedroom, two bedroom at the end of the hallway, and the converted garage. LPA observed that diaper changes were done in the converted garage. LPA discussed with Licensee that she cannot use the garage for children as it is not approved. Licensee stated that she will change diapers inside the home. LPA also observed that the bedroom across the den was being used for napping children. LPA inspected the room and observed that it is safe for the children. There are toys and equipment for children. Disinfectant and cleaning supplies were observed to be inaccessible to children. LPA discussed with Licensee that any blades for food processor, graters, or blenders need to be inaccessible. There is a fire extinguisher, but it was last serviced on 02/09/2018. LPA discussed with Licensee that fire extinguisher needs to be serviced every year or proof of purchase of new fire extinguisher every year. There is a smoke and carbon monoxide detector. Licensee does have a pet.

----------------continues on 809 dated 04/28/2024 page 2----------------------
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PATEL, AARTI VIBHESH
FACILITY NUMBER: 434413644
VISIT DATE: 04/18/2024
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The backyard is used and is fenced. The off-limit areas outside are the right side of yard and two sheds. There is a hot tub in the backyard, which is locked. There were no other bodies of water observed during today's inspection. There are play equipment for children. LPA observed that there was a shed that had tools and pesticide inside. Licensee moved tools and pesticides to a higher shelf during today's inspection. Licensee stated that she will make the left side yard off-limits and send proof to Licensing.

Upon entrance into the home, LPA observed that there was an infant asleep in a car seat. Licensee moved infant to a pack and play during inspection. LPA discussed with Licensee that car seats can only be used for transportation only. LPA discussed the safe sleep regulations with licensee 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 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. LPA reviewed the sleep logs. C-1 did not have LIC 9227 on file. There were infant asleep in the Den. The door was open slightly; however, Licensee is unable to see infant asleep without opening the door more.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

-----------------------continues on 809 dated 04/18/2024 page 3-------------------
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
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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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PATEL, AARTI VIBHESH
FACILITY NUMBER: 434413644
VISIT DATE: 04/18/2024
NARRATIVE
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Licensee does not transport children, but understands that children cannot be left alone and unattended in parked vehicles.

Licensee provides meals and snacks to children. LPA discussed with Licensee that children two and up are required to have fat free or 1% milk and all food containers brought from home need to have the child's name on it.

A copy of the facility roster was obtained. Nine (9) children's files were reviewed during today's inspection. The records reviewed include but not limited to immunization records.

Licensee and her assistants' files were reviewed. Licensee and A-1 have a valid CPR/1st Aid, which expires on 02/2026. Licensee and her assistant have completed the Mandated Reporter training and have immunization records on file.

The adults 18 and over living in the home are Licensee, her mother-in-law, father, and mother. Licensee also has one minor child. LPA discussed with Licensee to inform Licensing of any changes to adults living in the home. Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

----------------continues on 809 dated 04/18/2024 page 4----------------------------
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
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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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PATEL, AARTI VIBHESH
FACILITY NUMBER: 434413644
VISIT DATE: 04/18/2024
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---------------continuation of 809 dated 04/18/2024 page 3-------------------

An updated LIC 279 and LIC 279B was obtained during today's inspection.

Licensee will submit the following by 04/25/2024:
- proof of property (ig: property tax, mortgage, or deed)
- permission letter for temporary relocation sites
- updated LIC 999 to reflect the Sun Room being added
- LIC 9227 for C-1

As a result of this inspection, Type A and Type B citations were issued. Exit interview conducted and report was reviewed with Licensee Aarti Vibhesh Patel. A notice of site visit has been issued and must remain posted for 30 days.
LPA Samantha Yip informed Licensee, Aarti Vibhesh Patel, that this report dated 04/18/2024 document(s) three Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Samantha informed the Licensee to provide a copy of this licensing report dated 04/18/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
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Document Has Been Signed on 04/18/2024 05:10 PM - It Cannot Be Edited


Created By: Samantha Yip On 04/18/2024 at 02:44 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 04/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, which posed an immediate health, safety or personal rights risk to persons in care. LPA observed that there was a shed in the backyard that was not locked and had tools and chemicals, such as pesticides inside.
POC Due Date: 04/19/2024
Plan of Correction
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Deficiency was corrected during today's inspection. Licensee moved tools and chemicals to a higher shelf.
Type A
Section Cited
CCR
102416.3(a)(1)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (1) Conversion of a garage (either attached or detached) into a "child care" room.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to persons in care. LPA observed that diaper changes are done in the converted garage.
POC Due Date: 04/19/2024
Plan of Correction
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By 04/19/2024, Licensee will seize use of the converted garage. Licensee also will submit plan for where diaper changes will be completed; along with a statement that she understands that the coverted garage cannot be used.
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:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024


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Document Has Been Signed on 04/18/2024 05:10 PM - It Cannot Be Edited


Created By: Samantha Yip On 04/18/2024 at 02:44 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 04/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to persons in care. Licensee uses the converted garage to change children's diapers. LPA also observed that the bedroom across from the den was being used.
POC Due Date: 04/19/2024
Plan of Correction
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By POC 04/19/2024, Licensee will seize use of the garage and the bedroom across the den. Licensee will submit written statement that she understands that garage cannot be used.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024


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Document Has Been Signed on 04/18/2024 05:10 PM - It Cannot Be Edited


Created By: Samantha Yip On 04/18/2024 at 02:44 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 04/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(h)
Infant Safe Sleep
Car seats shall only be used for transportation purposes and shall not be used for sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
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3
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Based on observation, the licensee did not comply with the section cited above, which posed a potential health, safety or personal rights risk to persons in care. LPA observed that there was an infant asleep in the car seat.
POC Due Date: 04/25/2024
Plan of Correction
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By POC 04/26/2024, Licensee will submit written statement that she understands that car seat can only be used for transportation.

Licensee moved infant to a pack and play during today's inspection.
Type B
Section Cited
CCR
102425(j)(5)(A)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times. The provider shall be able to visually observe the infant without moving the door.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, which posed a potential health, safety or personal rights risk to persons in care. The door to the den was open; however Licensee is unable to visually observe the infants without moving the door.
POC Due Date: 04/25/2024
Plan of Correction
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By POC 04/25/2024, Licensee will submit that understands that door remain open at all time.

Licensee opened the door during today's inspection.
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:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024


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Document Has Been Signed on 04/18/2024 05:10 PM - It Cannot Be Edited


Created By: Samantha Yip On 04/18/2024 at 02:44 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 04/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
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2
3
4
Based on record review, the licensee did not comply with the section cited above, which poses a potential health, safety or personal rights risk to persons in care. C-1 did not have form on file.
POC Due Date: 04/25/2024
Plan of Correction
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3
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By POC 04/25/2024, Licensee will have parent fill out forms and send proof to Licensing.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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2
3
4
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:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024


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