434414738-9-22-2026-07-CC-FRAA-DY6UVU-20260922155544

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414738
Report Date: 09/22/2026
Date Signed: 09/22/2026 03:56:09 PM

Document Has Been Signed on 09/22/2026 03:56 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 CC RO, 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: 26	CENSUS: 20	DATE:	09/22/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:45 PM
MET WITH:	Farinaz Azarchehr		TIME VISIT/ INSPECTION 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	On 09/22/2026, Licensing Program Analyst (LPA), Farida Raja, met with Staff, Parul Desai for an unannounced annual 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. A tour of the facility was conducted including both indoor and outdoor areas. Upon arrival LPA observed 20 children with 2 staff (one teacher and one aide). Children were observed to be napping. Capacity and limitations as specified on the license are being maintained. Facility was in compliance with teacher to children ratio requirement. Classrooms, children restroom, staff restroom and kitchen were inspected. 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. 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. Floors in the facility are clean and safe. 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. Continued on Page 2

Gladys Kuizon
Farida Raja
	DATE: 09/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

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: BUTTERFLIES ACADEMY, INC	FACILITY NUMBER: 434414738
	VISIT DATE: 09/22/2026

NARRATIVE

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LPA observed fire extinguishers and smoke and carbon monoxide detector and the last fire inspection was conducted on 02/27/2026. Log shows that the last Fire Drill was conducted on 08/20/2026 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. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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 were inspected and observed to be fenced in and free of hazards There is adequate equipment, supplies, and toys for children outdoors. LPA observed play equipment was in good condition 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. LPA advised Director to follow manufacturer age recommendations on all play equipment.

Children sign in and out procedures and logs were reviewed. Children are signed in and out digitally using the Playground app. Children's roster was reviewed, and a copy was obtained. LPA reviewed a sample of four children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment.

Continued on Page 3

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

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: BUTTERFLIES ACADEMY, INC	FACILITY NUMBER: 434414738
	VISIT DATE: 09/22/2026

NARRATIVE

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Three staff files were reviewed. All teachers and staff maintain valid background clearances. The name of the child care center director or fully qualified teacher(s) designated to act in the director’s absence has been reported to the Department. Director stated that all staff have renewed the required Mandated Reporter Training but certificates have not been maintained in staff files. Staff S2 and S3 were observed to be missing proof of immunization's for measles and pertussis. Staff, S2 was also observed to be missing the health screening and proof of negative tuberculosis test. Director stated that both staff have completed immunization's and health screenings but records have not been maintained for review. Staff, S1 was observed to have proof of Pediatric CPR/First Aid Training. LPA reminded Director 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). LPA reminded Director that all personnel records shall be maintained at the child care center and shall be available to the licensing agency for review.

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.

LPA 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.

LPA discussed Reporting Requirements as outlined in the regulations (Section 101212) and the availability of resources provided by the Technical Support Program.

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). If present, medicines are stored in a high kitchen cabinet. Isolation of sick child was discussed, and Director explained that sick children will be isolated in the library area or away from other children and isolation equipment will be provided. Staff have one separate bathroom that can be utilized by sick children if needed. Child is always under visual supervision while in care of the facility.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

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: BUTTERFLIES ACADEMY, INC	FACILITY NUMBER: 434414738
	VISIT DATE: 09/22/2026

NARRATIVE

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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.

Per Title 22, Division 12, of the California Code of Regulations, one Type B deficiency was cited. Exit interview conducted and report was reviewed with Director, Farinaz Azarchehr. Appeal rights provided.

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: 09/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/22/2026 03:56 PM - It Cannot Be Edited

Created By: Farida Raja On 09/22/2026 at 03:21 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: BUTTERFLIES ACADEMY, INC	FACILITY NUMBER: 434414738
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/22/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review and interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Staff S2 and S3 were observed to be missing proof of immunization's for measles and pertussis. Staff, S2 is also missing the health screening and proof of negative tuberculosis test. Director stated that both staff have completed immunization's and health screenings but records have not been maintained for review.
	POC Due Date: 10/09/2026
	Plan of Correction
1 2 3 4	Director to submit missing records for staff S2 and S3 to LPA by plan of correction date of 10/09/2026.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: 09/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

LIC809 (FAS) - (06/04)

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