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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410399
Report Date: 07/25/2025
Date Signed: 07/28/2025 09:32:44 AM

Document Has Been Signed on 07/28/2025 09:32 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KRAJA, ALJBANAFACILITY NUMBER:
434410399
ADMINISTRATOR/
DIRECTOR:		KRAJA, ALJBANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 379-9401
CITY:SARATOGASTATE: CAZIP CODE:
95070
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 4DATE:
07/25/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Aljbana Kraja TIME VISIT/
INSPECTION COMPLETED:
05:40 PM
NARRATIVE
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Licensing Program Analyst (LPAs) Albert Mendoza and Farida Raja met with Licensee Aljbana Kraja for an Annual/Random Inspection. LPAs explained the nature of today’s inspection to Licensee. Present were Licensee, her husband, adult daughter and adult son and 4 day care children including 2 infants and 2 preschoolers. Days and hours of operation are Monday to Friday, 8:00 am to 5:00pm. Five adults and no minor children reside in the home.

A review of staff records on 07/23/2025 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Aljbana Kraja 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. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPAs toured the indoor and outdoor areas of the home during today’s inspection. Licensee was observed to be providing care to children in the covered patio, family room and master bedroom. LPAs observed that the home is clean and orderly, with heating, cooling and ventilation for safety and comfort of the children. LPAs observed sufficient materials, toys, and play equipment for the day care children.
NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 9
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KRAJA, ALJBANA
FACILITY NUMBER: 434410399
VISIT DATE: 07/25/2025
NARRATIVE
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LPAs observed a fully charged 3A40BC fire extinguisher and a working smoke and carbon monoxide detector. LPAs reminded Licensee that fire extinguishers needs to be serviced annually and service tag maintained for review. LPAs observed cleaning agents, laundry detergent, scissors, car cleaner and pet shampoo under the bathroom sink near the outdoor play area that is accessible to children. LPAs also observed unopened bottles of alcohol in lower shelf of the cabinet in the covered patio. Licensee moved the bottles to a higher cabinet during the inspection. LPAs observed a baby bouncer in the on limit covered patio. Licensee states there are no weapons/firearms in the home. Off limit areas indoors: one bedroom, kitchen, living room and den. Outdoor off limits: the garage, laundry room and the right side of the yard. The outdoor space and play equipment were observed to be age appropriate and free of hazards. Backyard was observed to fenced. Licensee states that she has one dog and 2 cats that are do not interact with the children. There are no bodies of water observed.
Bathroom used by children was in operating condition. Toilets and faucet are clean and operable.

LPAs observed one infant (C2) sleeping in a play yard with a blanket. Child was observed to be asleep in the master bedroom with the door closed while Licensee was in the covered patio with other children. LPAs also observed a preschool child asleep in a play yard in the covered patio with a pillow and blanket inside it. LPAs informed Licensee about safe sleep regulations and shared PIN 20-24-CCP during today's visit.

LPAs observed Licensee's CPR/First Aid expired on 10/27/2024 and Mandated Reporter Training expired on 12/16/2023. LPAs reminded Licensee that both training are required to be renewed every two years.

LPAs observed fire/disaster drill log which was last completed on 11/26/24. Licensee was reminded that fire drills need to be conducted every 6 months and documented. Licensee did not have a current roster of the children. LPAs reviewed 4 children's files. One infant (C1) was observed to be missing the Individual Infant Sleep Plan (LIC 9227) and both infants C1 and C2 were observed to be missing the 15 minute sleep log. LPAs provided Licensee with a sample sleep log during today's inspection. Licensee informed families that they do not have insurance for the daycare. LIC 282 was on file. Supervision of children was discussed with Licensee and she understands that the licensee must be present in the home during day care hours and ensure that the children are supervised at all times. LPAs reminded Licensee that 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. LPAs reminded licensees that all equipment used in the day care must follow manufacturer's instructions for use.
NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
LIC809 (FAS) - (06/04)
Page: 3 of 9
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: KRAJA, ALJBANA
FACILITY NUMBER: 434410399
VISIT DATE: 07/25/2025
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Incidental Medical Services (IMS) policy was discussed. Licensee stated that she is not administering any medications or IMS. 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: http://www.ada.gov/childqanda.htm.

Licensee Ajlbana Kraja, 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. During the exit interview, Licensee Ajlbana Kraja, confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

Two Type A citations and 8 Type B citations were issued. LPAs informed licensee, Aljbana Kraja that this report dated 07/25/2025 documents two Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPAs informed the licensee to provide a copy of this licensing report dated 07/25/2025 that documents any Type A citations 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.

Exit interview conducted and report was reviewed with the Licensee Aljbana Kraja. Appeal rights and LIC 9224 were printed and provided to Licensee.

A notice of site visit was given to Licensee Aljbana and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
LIC809 (FAS) - (06/04)
Page: 4 of 9
Document Has Been Signed on 07/28/2025 09:32 AM - It Cannot Be Edited


Created By: Farida Raja On 07/25/2025 at 03:56 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: KRAJA, ALJBANA
FACILITY NUMBER: 434410399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2025

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 poses an immediate health, safety or personal rights risk to persons in care. LPAs observed cleaning agents, laundry detergent, scissors, car cleaner and pet shampoo under the bathroom sink near the outdoor play area that is accessible to children. LPAs also observed unopened bottles of alcohol in lower shelf of the cabinet in the covered patio.
POC Due Date: 07/26/2025
Plan of Correction
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Licensee will send photos to CCLD within 24 hours of cleaning compounds and other hazards removed or made inaccessible to children.
Type A
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

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. LPAs observed one infant (C2) sleeping in a play yard with a blanket. Child was observed to be asleep in the master bedroom with the door closed while Licensee was in the covered patio with other children. LPAs also observed a preschool child asleep in a play yard in the covered patio with a pillow and blanket inside it.
POC Due Date: 07/26/2025
Plan of Correction
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Licnesee will send a written statement to CCLD within 24 hours explaining she understands the safe sleep regulations and will keep all loose articles out of play yards and cribs.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Farida Raja
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2025


LIC809 (FAS) - (06/04)
Page: 5 of 9
Document Has Been Signed on 07/28/2025 09:32 AM - It Cannot Be Edited


Created By: Farida Raja On 07/25/2025 at 03:56 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: KRAJA, ALJBANA
FACILITY NUMBER: 434410399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
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: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and 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.
POC Due Date: 08/15/2025
Plan of Correction
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Licensee will submit a photo to CCLD by POC date showing that they have conducted a fire drill.
Type B
Section Cited
CCR
102417(g)(10)
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: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).

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 a potential health, safety or personal rights risk to persons in care. LPAs observed a baby bouncer in the on limit covered patio.
POC Due Date: 08/15/2025
Plan of Correction
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Licensee will submit a picture that the baby bouncer is put away and no longer in use by the children.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Farida Raja
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2025


LIC809 (FAS) - (06/04)
Page: 6 of 9
Document Has Been Signed on 07/28/2025 09:32 AM - It Cannot Be Edited


Created By: Farida Raja On 07/25/2025 at 03:56 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: KRAJA, ALJBANA
FACILITY NUMBER: 434410399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(5)
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.

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 poses a potential health, safety or personal rights risk to persons in care. LPAs observed one infant (C2) sleeping in a play yard with a blanket. Child was observed to be asleep in the master bedroom with the door closed while Licensee was in the covered patio with other children.
POC Due Date: 08/15/2025
Plan of Correction
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Licensee will submit a written letter to CCLD explaing that she understands safe sleep regulations and that doors must remian open when children are sleeping in another room by POC Date.
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
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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. Licensee's Mandated Reporter Training expired on 12/16/2023 and has not been renewed.
POC Due Date: 08/15/2025
Plan of Correction
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Liceense will submit to CCLD a picture of her updated Mandated Reporter Training certificate by POC date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Farida Raja
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2025


LIC809 (FAS) - (06/04)
Page: 7 of 9
Document Has Been Signed on 07/28/2025 09:32 AM - It Cannot Be Edited


Created By: Farida Raja On 07/25/2025 at 03:56 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: KRAJA, ALJBANA
FACILITY NUMBER: 434410399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
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. Licensee did not have a current roster of the children.
POC Due Date: 08/15/2025
Plan of Correction
1
2
3
4
Licensee will submit a updated roster to CCLD by POC Date
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. One infant (C1) was observed to be missing the Individual Infant Sleep Plan (LIC 9227)
POC Due Date: 08/15/2025
Plan of Correction
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2
3
4
Licensee will submit a LIC 9227 for child, C1 to CCLD by POC Date
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Farida Raja
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2025


LIC809 (FAS) - (06/04)
Page: 8 of 9
Document Has Been Signed on 07/28/2025 09:32 AM - It Cannot Be Edited


Created By: Farida Raja On 07/25/2025 at 03:56 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: KRAJA, ALJBANA
FACILITY NUMBER: 434410399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview and record review, the licensee did not comply with the section cited above for two infants, C1 and C2 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/15/2025
Plan of Correction
1
2
3
4
Licensee will begin to do 15 min checks on infants under two years and will submt a sleeping log to CCLD by POC date
Type B
Section Cited
CCR
102416(c)
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview and record review, the licensee did not comply with the section cited above for herself which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/15/2025
Plan of Correction
1
2
3
4
Licensee to complete the Pediatric CPR/ First Aid training and submit certificate to LPA by 08/15/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Farida Raja
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2025


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