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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408478
Report Date: 10/23/2026
Date Signed: 10/27/2026 08:55:24 AM

Document Has Been Signed on 10/27/2026 08:55 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:SIDHU, KANWALJITFACILITY NUMBER:
434408478
ADMINISTRATOR/
DIRECTOR:		SIDHU, KANWALJITFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 564-5012
CITY:Santa ClaraSTATE: CAZIP CODE:
95051
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
10/23/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Kanwaljit SidhuTIME VISIT/
INSPECTION COMPLETED:
01:25 PM
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On 10/23/2026, Licensing Program Analysts (LPAs) Tra Dinh and Pedro Gutierrez conducted an unannounced annual/random inspection. LPAs were granted access to the home by Licensee, Kanwaljit Sidhu and explained the purpose of today’s inspection. Present in the home were licensee, her spouse (S1), her son (S2) and four preschool children. Three more preschool children arrived during the inspection. Licensee is operating within the ratio and capacity requirements of the license. Days and hours of operation are Monday to Fridayy, 8:00 am to 6:00 pm. LPAs observed all required posted materials in the living room of the home. Adults living in the home are Licensee, S1, licensee’s adult sons (S2 and S3), and no minor children residing at the home.

LPAs toured the indoor and outdoor areas of the home during today's inspection. During the walk through, LPAs observed the garage was being used for daycare purposes. The garage is an off-limit area and not approved for daycare use. Licensee was not in compliance. Licensee has a working telephone in the home. LPAs observed some toys and play equipment for day care children. The child care area has portable air condition unit and ventilation for comfort of children. The home is single-story home. There are no stairs or fireplaces inside the home. The off-limit areas inside the home are: two bedrooms, kitchen, living room, attached garage. LPAs observed numerous accessible chemicals and cleaning products under the sink within the garage bathroom which is a room that children nap in. LPAs also observed medications underneath the on-limit bathroom sink that was not locked and accessible to children in care.

LPAs observed a 3A40BC fire extinguisher which was serviced on 04/05/2023 and a combination working smoke and carbon monoxide detector. Licensee states that she does not have any weapons or pets in the home. Licensee was reminded to purchase or service the fire extinguisher annually and service tag or purchase receipt should be available for The Department to review.

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Susy Cervantes
Tra Dinh
DATE: 10/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SIDHU, KANWALJIT
FACILITY NUMBER: 434408478
VISIT DATE: 10/23/2026
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Licensee submitted LIC 279 Application for A Family Child Care Home License and LIC 610A Emergency Disaster Plan for Family Child Care Home.

Licensee understands that smoking is prohibited in the home.

Licensee stated that she provided lunch and snacks to children in care. Licensee understands that any food/drink provided by parent(s) needs to be properly labeled with the child(ren) name and properly stored or refrigerated.

The outdoor space and play equipment were observed to be age appropriate. Backyard is fenced and gated on one side. There were no bodies of water observed. Off limit area outside the home is the left side section which includes the locked storage.

Licensee has a designated area in the home where a child can be isolated if exhibiting signs of illness until parent pick up. LPAs reviewed a current child care facility roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was last conducted on 10/15/2026. LPAs obtained copy of children's roster.

LPAs reviewed two children's files during today's inspection. Licensee stated that she has liability insurance for the day care. All children's files were observed to be completed with the required forms and immunization records.

LPAs 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. LPAs reminded Licensee that sleep sacks and swaddles are were not permitted for infants.

LPAs 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.

LPAs reviewed Licensee for the required forms. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. Licensee has current Pediatric CPR/First Aid certification which expires on 10/06/2028 and Mandated Reporter Training expires on 01/26/2028. Licensee has the required immunizations on file.

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NAME OF LICENSING PROGRAM MANAGER: Susy Cervantes
NAME OF LICENSING PROGRAM ANALYST: Tra Dinh
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2026
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SIDHU, KANWALJIT
FACILITY NUMBER: 434408478
VISIT DATE: 10/23/2026
NARRATIVE
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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.

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. LPAs discussed "zero tolerance" related regulations which includes the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. A $500 immediate civil penalty is assessed for serious violations such as absence of supervision, accessible bodies of water, accessible firearms, refused entry of licensing staff, presence of an excluded person, and violations that result in illness or injury. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

LPAs discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider information Notices (PINs) and Quarterly Updates. LPAs discussed Reporting Requirements as outline in the regulations (Section 102416.2).

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. Licensee states that no children require medications or IMS at this time. 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/.

Licensee states that she does not transport any day care children. LPAs reminded Licensee that if she decides to transport children, children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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NAME OF LICENSING PROGRAM MANAGER: Susy Cervantes
NAME OF LICENSING PROGRAM ANALYST: Tra Dinh
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2026
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SIDHU, KANWALJIT
FACILITY NUMBER: 434408478
VISIT DATE: 10/23/2026
NARRATIVE
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Exit interview conducted and report was reviewed with Licensee, Kanwaljit Sidhu. During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

One type A deficiency and one type B deficiency were issued as a result of today's inspection. Appeal rights were provided.

LPA Tra Dinh informed licensee, Kanwaljit Sidhu that this report dated 10/23/2026 documents one Type A citation which shall be posted for 30 consecutive days as there is risk to the health, safety, or personal rights of children in care. Also, LPA Tra Dinh informed the licensee Kanwaljit Sidhu to provide a copy of this licensing report dated 10/23/2026 that documents any Type A citation 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.

A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 Acknowledgement of Receipt of Licensing Reports was given to Licensee Kanwaljit Sidhu.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

NAME OF LICENSING PROGRAM MANAGER: Susy Cervantes
NAME OF LICENSING PROGRAM ANALYST: Tra Dinh
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/27/2026 08:55 AM - It Cannot Be Edited


Created By: Tra Dinh On 10/23/2026 at 12:03 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: SIDHU, KANWALJIT
FACILITY NUMBER: 434408478

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
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 observations, the licensee did not comply with the section cited above: LPAs observed numerous accessible chemicals and cleaning products under the sink within the garage bathroom which is a room that children nap in and LPAs observed medications underneath the on-limit bathroom sink that was not locked and accessible to children in care, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/30/2026
Plan of Correction
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Licensee will remove hazardous items to off- limit areas or install locks to prevent access and licensee will submit the letter that she understands the safety risks of children in care by POC due date, October 30, 2026.
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.
Susy Cervantes
NAME OF LICENSING PROGRAM MANAGER:
Tra Dinh
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/27/2026 08:55 AM - It Cannot Be Edited


Created By: Tra Dinh On 10/23/2026 at 12:04 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: SIDHU, KANWALJIT
FACILITY NUMBER: 434408478

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.3(a)(1)

102416.3(a)(1) - Prior to making alterations or ...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 and interview, the licensee did not comply with the section cited above: LPAs observed the garage was being used for daycare purposes. The garage is an off-limit area and not approved for daycare use, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/26/2026
Plan of Correction
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Licensee needs to cease using the garage immediatly and licensee must submit a written statement of their understanding of the regulation and their plan to prevent this from happening again by POC due date, October 26, 2026.
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.
Susy Cervantes
NAME OF LICENSING PROGRAM MANAGER:
Tra Dinh
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2026


LIC809 (FAS) - (06/04)
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