434410840-5-15-2023-07-CC-FRAA-CRV4R8-20230515191931

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410840
Report Date: 05/12/2023
Date Signed: 05/15/2023 07:19:44 PM

Document Has Been Signed on 05/15/2023 07:19 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:	SHAH, ROSHNI & SHAILA		FACILITY NUMBER:	434410840
ADMINISTRATOR:	R/S SHAH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 223-7242
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95148
CAPACITY:	14	CENSUS: 8	DATE:	05/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Shaila Shah		TIME COMPLETED:	04:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced 1- year annual inspection. LPA was granted access to the home by Licensee, Shaila Shah and explained the nature of today’s inspection. Present in the home were licensee, spouse/assistant and eight children including two infants and six preschool age. Licensee was operating within the ratio and capacity requirements of her license. Days and hours of operation are Monday to Friday, 7:30 am - 5 pm and licensee stated that starting July, 2023 licensee will change daycare hours from 7:30 am-3:30 pm. LPA observed all required posted materials near the front entrance to the home. The adults that reside in the home are licensee, spouse (Dipak Shah) and adult daughter (Roshni Shah). LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (408-223-7242). LPA observed sufficient materials, toys, and play equipment for the day care children both indoors and outdoors. Furniture, such as tables, chairs, cribs, feeding chairs, bookcases and shelves, are in good condition. The floors were free of tripping hazards with toys put away on shelves. The home has central heating/cooling and ventilation for comfort of children. The home is single story. Off limit areas inside the home: four bedrooms, one bathroom, attached garage and barricaded fireplace in on-limits family room. Off limit areas outside the home: left and right side sections of the backyard. Backyard is fenced and both sides of the home are gated. There are no bodies of water. LPA observed that the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. The shower area is free on any hazards. LPA observed a fully charged 3A40BC fire extinguisher in the kitchen area and working smoke/carbon monoxide detectors. The Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, medications, sharp objects and other similar items are stored inaccessible to children. Licensee understands that smoking is prohibited in the home.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

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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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: SHAH, ROSHNI & SHAILA	FACILITY NUMBER: 434410840
	VISIT DATE: 05/12/2023

NARRATIVE

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Drinking water is readily available for children in the home via individual water bottles. Licensee states that she provides breakfast, lunch and two snacks to the children in care. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored or refrigerated. The licensee provides weekly menu to the parents and understands that food allergies and dietary restrictions shall be followed and outlined in the children’s files. Licensee stated that she is part of the Love Little Children Food Program.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was conducted on 5/9/2023. Licensee is part of the Early Head Start (EHS) program and conducts monthly fire drills. LPA obtained a copy of the children's roster. Children file review was completed and found to be current and up to date. Eight (8) children’s files were reviewed during today's inspection. Licensee 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 15- minute nap checks conducted and logged by licensee.

Staff file review was completed and found to be current and up to date. All individuals have clearances for Tuberculosis, Criminal Background, and Child Abuse Index Checks. LPA reviewed two staff files (Licensee and spouse/assistant) and the files were complete with the required forms. Licensee and spouse have current Pediatric CPR/First Aid certification with an expiration date of 09/2024. Licensee and spouse have proof of immunization in file for measles, pertussis and influenza and their Mandated Reporter Training expires on 6/27/2024. Licensee understands the training is mandatory to all Licensees and adults in the home in contact will children and requires renewal every two years.

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 Licensee understands her capacity options and she 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 an assistant her license capacity is reduced to 8 and ratio (age of the children) must be observed.

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. A $500 immediate civil penalty

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

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: SHAH, ROSHNI & SHAILA	FACILITY NUMBER: 434410840
	VISIT DATE: 05/12/2023

NARRATIVE

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and $100 per day violation until corrected 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. Licensee is encouraged to visit the Department’s website at https://cdss.ca.gov/inforesources/child-care-licensing to access general updates, resources for providers, regulations, adoptions of new laws, pay annual fees etc.

Licensee states that a child will be isolated in the living room if necessary due to illness or communicable disease to wait for parent pick up. Licensee states that she does not administer any medications to the day care children at this time. She will submit a plan of operation if in the future she provides any IMS services to a child in care. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. The following information regarding Americans with Disabilities Act (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 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 shall only be used for transportation and shall not be used for sleeping.

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@dess.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.

Exit interview conducted and report was reviewed with the Licensee, Shaila Shah .

As a result of today's inspection, there were no deficiencies cited.

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

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

LIC809 (FAS) - (06/04)

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