434414738-9-29-2025-07-CC-FRAA-DLYS7U-20250929133807

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414738
Report Date: 09/29/2025
Date Signed: 09/29/2025 01:38:20 PM

Document Has Been Signed on 09/29/2025 01:38 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:	BUTTERFLIES ACADEMY, INC		FACILITY NUMBER:	434414738
ADMINISTRATOR/ DIRECTOR:	AZARCHEHR, FARINAZ		FACILITY TYPE:	850
ADDRESS:	14103 SARATOGA AVE.		TELEPHONE:	(408) 867-3772
CITY:	SARATOGA	STATE: CA	ZIP CODE:	95070
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 24	DATE:	09/29/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:35 AM
MET WITH:	Farinaz Azarchehr		TIME VISIT/ INSPECTION COMPLETED:	01:50 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	On 09/29/2025, Licensing Program Analyst (LPA), Farida Raja, met with Staff, Parul Desai for an unannounced Required -3 Year inspection. LPA informed staff of the purpose for today's inspection. Director, Farinaz Azarchehr arrived a few minutes later. The facility is licensed to serve 30 children ages 2-6 years in one room. LPA observed all required posted materials near the facility entrance. Days and hours of operation are Monday through Friday, 8:00 AM to 5:30 PM. LPA and Director toured the facility during today's inspection and observed the following ratios. Upon arrival LPA observed 13 children with 2 staff. Children continued to arrive during the inspection. Facility was in compliance with teacher to children ratio requirement. Classrooms, children's restroom, staff restroom and kitchen were inspected. Children were engaged in free play and circle time under the visual supervision of teachers. Facility has central heating and LPA observed portable air conditioners and fans for cooling. Director states that there are no weapons or firearms on the premises. There is a working telephone at the facility. Disinfectants and cleaning products were observed to be stored in high cabinets in the staff bathroom. Director stated that the facility is cleaned by third party cleaners once a week. Per director, no children require medications at this time. If present, medicines are stored in a high kitchen cabinet. Knives and sharps were observed to be placed out of reach of children. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Director stated that children eat outdoors and LPA observed solid waste containers with tight-fitting lids in the outdoor area. LPA observed appropriate changing table and a trash can with tight fitting cover for the disposal of diapers. Napping mats are appropriate. Restrooms and sinks for children were observed to be safe, sanitary, and in working condition. Staff has one separate bathroom that can be utilized by sick children if needed. Continued on Page 2

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: BUTTERFLIES ACADEMY, INC	FACILITY NUMBER: 434414738
	VISIT DATE: 09/29/2025

NARRATIVE

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LPA observed fire extinguishers and working smoke and carbon monoxide detector. Log shows that the last Fire Drill was conducted on 09/19/2025 which is compliant with the six-month requirement for facilities.

Drinking water is readily available for children in each room and in the outdoor playground area via individual water bottles which are refilled using filtered water. Water lead testing was completed for the facility on 08/18/2022 and no Action Level Exceedances were reported.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA shared a copy of PIN 21-21.1-CCP with the Director during today's inspection.

LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. LPA provided Director with the Water Lead Report from the California State Water Resources Control Board during today's inspection.

Parents provide all meals and snacks for the children. Food storage areas were observed to be sanitary. All food and beverages that require refrigeration are stored in covered containers. Director understands that any food/water bottles brought from home shall be labeled with each child's name and properly stored or refrigerated.

Outdoor playground and play equipment was inspected and observed to be fenced in and free of hazards. LPA observed play equipment was in good condition, age-appropriate, and has sufficient tan bark as resilient material to absorb falls. Areas around and under high climbing equipment and slides were cushioned with resilient material. Shaded rest area is provided by trees and building overhang. There were no bodies of water observed. There is adequate equipment, supplies, and toys for children outdoors. Director informed LPA that children also use the lower outdoor yard for outside play. LPA toured and measured the added outdoor area during today's inspection. Director provided a facility sketch of the lower outdoor yard during today's inspection.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025

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: BUTTERFLIES ACADEMY, INC	FACILITY NUMBER: 434414738
	VISIT DATE: 09/29/2025

NARRATIVE

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Measurements for upper outdoor yard were taken by LPA Monico on 8/17/16 and measure 1614.41 sq.ft. Measurements obtained for the lower outdoor yard taken during today's inspection are 5475.50 sq.ft. Outdoor total measurements contain a total of 7089.91 square feet, which will accommodate Director's request for 30 preschool children. LPA observed that the upper and lower yard are separated by a gate. Playground waiver dated 05/14/2018 to not exceed 21 children in the outdoor area is no longer required.

Children sign in and out procedures and logs were reviewed. Children are signed in and out digitally using the Brightwheel app. Children's roster was reviewed, and a copy was provided to the LPA. LPA reviewed 7 children’s files during today's inspection. Each child's file reviewed contained the required forms.

Three staff files (Director and two teacher's) were reviewed. All teachers and staff maintain valid background clearances. All staff files reviewed contain the required transcripts/verification of experience. All staff have current CPR and First Aid certification. LPA informed Director that the Department does not accept online CPR and First Aid certification and the training needs to be in person or include an in persons skills session. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). All staff have the required immunization's against pertussis, measles and statement declining the influenza immunization. LPA observed required Mandated Reporter Training on file for all staff.

Director was reminded that all adults 18 and over, 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 Child Care Center. 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.

Director will submit an updated Designation of Facility Responsibility (LIC 308), Personnel Report (LIC 500), Application for a Child care Center License (LIC 200A)and Emergency Disaster Plan (LIC 610) to LPA by 10/13/2025.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. Director stated that facility does not currently have children in care who require medications or Incidental Medical Services (IMS).

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: BUTTERFLIES ACADEMY, INC	FACILITY NUMBER: 434414738
	VISIT DATE: 09/29/2025

NARRATIVE

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Isolation of sick child was discussed, and Staff explained that sick children will be isolated in the library area or away from other children and isolation equipment will be provided. Child is always under visual supervision while in care of the facility. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility does not provide transportation to children. Director 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.

As a result of today's inspection, there were no deficiencies cited. Director could not be present for the entirety of the inspection. Exit interview conducted and report was reviewed with Staff, Parul Desai.

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

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025

LIC809 (FAS) - (06/04)

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