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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430701361
Report Date: 11/05/2024
Date Signed: 11/05/2024 10:00:21 AM

Document Has Been Signed on 11/05/2024 10:00 AM - 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ACTION DAY NURSERYFACILITY NUMBER:
430701361
ADMINISTRATOR/
DIRECTOR:		BATE, STEPHANIEFACILITY TYPE:
850
ADDRESS:2146 LINCOLN AVENUETELEPHONE:
(408) 266-8952
CITY:SAN JOSESTATE: CAZIP CODE:
95125
CAPACITY: 154TOTAL ENROLLED CHILDREN: 122CENSUS: 108DATE:
11/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Smriti DataTIME VISIT/
INSPECTION COMPLETED:
10:10 AM
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On 11/5/2024, at 9:10 AM, Licensing Program Analyst (LPA) Liridon Fici-Doni arrived unannounced to conduct a case management visit to deliver civil penalties dated for 10/24/2024. LPA was greeted by Director, Smriti Data and explained the purpose of the visit.

On 10/24/2024, the center was cited for a type B, under section 101229(a)(1)- Responsibility for Providing Care and Supervision. LPA was informed that Children in classroom 10 were being unsupervised and unattended for while teachers were taking children to the bathroom.

On 04/11/2024, a child (C1) was left alone unsupervised outside and was found in the parking lot.


A civil penalty of $1000.00 is being assessed during today's inspection.

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




Exit interview conducted with Director, and this report reviewed and provided along with appeal rights.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Liridon Fici
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2024
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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