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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413722
Report Date: 03/07/2023
Date Signed: 03/07/2023 09:25:24 PM


Document Has Been Signed on 03/07/2023 09:25 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:SANDHU, SUKHDEEPFACILITY NUMBER:
434413722
ADMINISTRATOR:SANDHU, SUKHDEEPFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 702-5700
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY:14CENSUS: 10DATE:
03/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Sukhdeep SandhuTIME COMPLETED:
05:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs), Farida Raja and Anna Morales, conducted an unannounced 1- year annual inspection. LPAs were granted access to the home by Licensee, Sukhdeep Sandhu and explained the nature of today’s inspection. LPAs observed 2 adults (Licensee and assistant- Andrea Vargas ) and 10 children( 4 infants, 6 preschool aged) in the home during today’s inspection. Licensee was operating within the ratio and capacity requirements of her license. Days and hours of operation are Monday to Friday 8:30 am to 5:30 pm. LPA observed all required posted materials, including facility license, Notification of Parents' Rights and Earthquake Prepardness near the front entrance to the home. The adults that reside in the home are Licensee and spouse Jagvinder Sandhu. Licensee has 2 minor children, ages 9 and 12 residing in the home. Licensee's children arrived after school at 2:44pm while LPAs were present.

LPAs toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (408-702-5700). LPA inspected home for any health and safety hazards. LPA observed age-appropriate materials, toys, and play equipment in the facility. The floors were free of tripping hazards with toys put away in bins/baskets. LPA observed play equipment were maintained in a good condition, free of hazards. The home has central heating/cooling and ventilation for comfort of children. A thermostat was observed. The home is a single story with no staircases. Off limit areas inside the home include master bedroom, 3 bedrooms, 1 bathroom, kitchen, dining area and attached garage. The family room has a barricaded fireplace. Off limit areas outside the home: right side section of the backyard, pool, and storage shed. The pool has a 3 ft metal fence and a 5 feet mesh fence surrounding it. The gate leading to the pool is self latching, locked and swings away from the pool. Backyard is fenced and both sides of the home are gated. LPA observed a swing structure in the backyard that is safe and secure for the children.

LPA observed a fully charged 2A10BC fire extinguisher in the kitchen area and working smoke/carbon monoxide detectors. Licensee states there are weapons/firearms in the home. LPA observed that firearms are stored in a safety vault located in an off limits bedroom. The ammunition is stored and locked in a
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2023
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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Document Has Been Signed on 03/07/2023 09:25 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: SANDHU, SUKHDEEP
FACILITY NUMBER: 434413722

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(f)
Infant Safe Sleep
An infant shall not be swaddled while in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
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4
Based on LPAs observations C1 and C3 were swaddled during nap time. The licensee did not comply with the section cited above in 2 out of 4 infants which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/08/2023
Plan of Correction
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Licensee will submit a written statement to LPA Raja, stating that she understands the safe sleep regulations and ensure that she does not swaddle infants at all times. Licensee will submit written statement to LPA by POC date of 03/08/2023. AB 633 requirements was explained to licensee and she understood them.
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: Gladys KuizonTELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2023
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Document Has Been Signed on 03/07/2023 09:25 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: SANDHU, SUKHDEEP
FACILITY NUMBER: 434413722

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/07/2023

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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Based on observation, interview and record review, the licensee did not comply with the section cited above in C1, C2 and C3 missing LIC 9227 Infant Sleeping Plan which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/21/2023
Plan of Correction
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Licensee will submit a copy of LIC 9227 for all 3 infants to LPA Raja by POC date 03/21/2023. Licensee was able to have authorized representatives complete LIC 9227 for infants C1, C2 and C3 and showed proof to LPA on day of inspection (03/07/2023).
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Gladys KuizonTELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2023
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SANDHU, SUKHDEEP
FACILITY NUMBER: 434413722
VISIT DATE: 03/07/2023
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separate box. The Licensee states that she does not have any pets in the home. All detergents, cleaning compounds, medications, sharp objects and other similar items are stored inaccessible to children. All poisons are inaccessible to children. Licensee has a first aid kit in the kitchen area of the home. Licensee understands that smoking is prohibited in the home.

Drinking water is readily available for children in the home via labelled sippy cups/cups. Licensee states that she provides meals(breakfast and lunch) and snacks to the children in care.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was conducted on 3rd February, 2023. LPA obtained a picture of children's roster dated 05/24/2022. Five (5) children’s files were reviewed during today's inspection for the following records: Notification of Parents Rights (LIC995A), Consent for Emergency Medical Treatment (LIC627), Identification and Emergency Information (LIC700), and Immunization Records (PM 286/CDPH 286). Licensee states that she does not have liability insurance for the day care and issues the Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282). LPA reviewed three infant (under 12 months) children's files and all were missing the Individual Infant Sleeping Plan (LIC 9227). LPA arrived at nap time and observed 2 swaddled infants. Licensee stated that she does monitor napping children but does not conduct the required 15-minute sleep checks on infants. LPA issued a technical violation for 102425(j)(1)(2).

LPA discussed the safe sleep regulations with Licensee, including but not limited to documentation that shall be maintained. LPA discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA reviewed two staff files (Licensee and one adult assistant) and the files were complete with the required forms. Licensee and helper has current CPR and First Aid certifications (expiration: 08/11/2023 and 02/26/2025 respectively). Licensee and staff have the required vaccines (MMR, Tdap, & flu shot) and are current with Mandated Reporter Training for Child Care Workers. Licensee's and assistant's Mandated Reporter Training expires on 02/26/2025.

Supervision of children was discussed with Licensee and she understands that she or a qualified adult must be present in the home during day care hours and ensure that the children are supervised at all times. The
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SANDHU, SUKHDEEP
FACILITY NUMBER: 434413722
VISIT DATE: 03/07/2023
NARRATIVE
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Licensee understands her capacity options and understands that she cannot have more than 14 children in the home at any time and a qualified assistant must be present. Licensee understands in absence of a helper her license capacity is reduced to 8 and ratio (age of the children) must be observed.

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed "zero tolerance" related regulations and advised that the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected. Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov/ www.ccld.ca.gov to access resources for providers, regulations, adoptions of new laws, pay annual fees etc.

Licensee states that a child will be isolated in the living area next to the kitchen due to illness or communicable disease. Licensee states that she does not administer any medications to the day care children at this time. Incidental Medical Services (IMS) policy was discussed. 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.

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.



The Licensee states that she does not transport any day care children. LPA reminded Licensee that if she decides to transport children, children should not be left unattended in parked vehicles and that car seats
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SANDHU, SUKHDEEP
FACILITY NUMBER: 434413722
VISIT DATE: 03/07/2023
NARRATIVE
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shall only be used for transportation and shall not be used for sleeping.

In areas that were evaluated, regulatory violations were observed. One Type A and Type B deficiency cited as a result of today's inspection. Appeal rights and LIC 9224 were printed and given to Licensee.

Exit Interview was conducted, where this report, the citations, plan of corrections, and appeal rights were reviewed and discussed with Licensee, Sukhdeep Sandhu. Citations are issued on 809-D pages of this report. Licensee signed the report acknowledging receipt of documents. LPA reminded Licensee that failure to correct deficiencies by Plan of Correction Due Date may result in penalties of $100 per day per violation.

Due to the issuance of a Type A Citation during today's inspection, a copy of this Licensing Report must be given to each existing parent by the end of today or next day child is in care, and to the parent of children enrolled over the next 12 months. In addition, a copy of the LIC 9224 Acknowledgement of Receipt of Licensing Reports must be signed by each parent and kept in each child's file.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023
LIC809 (FAS) - (06/04)
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