434415158-9-16-2024-07-CC-FRAA-D96V2G-20240916160309

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415158
Report Date: 09/16/2024
Date Signed: 09/16/2024 04:03:15 PM

Document Has Been Signed on 09/16/2024 04:03 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:	KHUNKHUN, JASWANT		FACILITY NUMBER:	434415158
ADMINISTRATOR/ DIRECTOR:	KHUNKHUN, JASWANT		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 416-6810
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95148
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 7	CENSUS: 6	DATE:	09/16/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:48 AM
MET WITH:	Jaswant Khunkhun		TIME VISIT/ INSPECTION COMPLETED:	11:15 AM

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 09/16/2024 at 8:48am, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced annual/random inspection. LPA was granted access to the home by Licensee, Jaswant Khunkhun, and explained the nature of today’s inspection. Present in the home were licensee, one assistant/son and 6 children including two infants and four preschool age. Licensee was operating within the ratio and capacity requirements of the license. Days and hours of operation are Monday to Friday, 8:30 AM to 6:00 PM. LPA observed all required posted materials in the living room of the home. LPA advised licensee to have postings clearly posted near the entrance so it is visible to parents/authorized representatives. The adults that reside in the home are licensee and two sons. LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Furniture, high chairs, crib, nap mats and toys are in good condition. The home has central heating/cooling and ventilation for comfort of children. The home is multi story and LPA observed barricaded stairs during today's inspection. LPA observed a barricaded fireplace in the on limit family room. Off limit areas inside the home: entire upper level, living room, kitchen, dining room, laundry room and attached garage. Off limit areas outside the home: upper level deck area. The outdoor space and play equipment were observed to be age appropriate. LPA observed rubber mats as resilient material under play structures. Backyard is fenced and gated. No bodies of water were observed. LPA observed that the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. The shower area is free of any hazards. LPA reminded licensee that if an 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. The provider shall be able to visually observe the infant without moving the door. Licensee will submit an updated Facility Sketch (LIC 999A) to LPA by 09/30/2024. Continued on Page 2

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2024

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: KHUNKHUN, JASWANT	FACILITY NUMBER: 434415158
	VISIT DATE: 09/16/2024

NARRATIVE

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LPA observed a fully charged 2A10BC fire extinguisher and working smoke/carbon monoxide detector. LPA reminded licensee that the fire extinguisher needs to be serviced once every 12 months. Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, poisons, medications, sharp objects and other similar items are stored inaccessible to children. Licensee understands that smoking is prohibited in the home.

Drinking water is readily available for children in the home via individual water bottles and refilled using a water pitcher with filtered water. Licensee states that she provides breakfast, lunch and 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. Licensee states that a child will be isolated in the on limit bedroom if necessary due to illness or communicable disease.

LPA reviewed a current child care facility roster and fire/disaster drill log during today's inspection. Licensee stated that the last fire/disaster drill was conducted on 06/01/2024. LPA reminded Licensee that fire drill need to be conducted at least once every six months and documented. LPA obtained copy of children's roster.

Children file review was completed and found to be current and up to date. Six (6) children’s files were reviewed during today's inspection. Licensee carries daycare insurance but policy expired on 01/07/2024. Licensee stated that she has current insurance and will email a copy to LPA once she receives it from the insurance company. LPA reviewed two infant's files. Licensee is not caring for any children under 12 months at this time. LPA observed 15 minute nap checks conducted for infant children until end of July. LPA reminded Licensee that nap checks need to be conducted and documented for all infants until they are 2 years of age. LPA provided licensee with a copy of an Individual Infant Sleeping Plan (LIC 9227) during today's inspection.

LPA 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. LPA 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.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2024

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: KHUNKHUN, JASWANT	FACILITY NUMBER: 434415158
	VISIT DATE: 09/16/2024

NARRATIVE

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LPA reviewed two staff files (Licensee and assistant) for the required forms and found them to be current and up to date. 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 or exemptions.
Licensee has current Pediatric CPR/First Aid certification which expires on 10/03/2024. Licensee and staff have the required immunization in file for measles, pertussis and statement declining influenza. Licensee and staff have current Mandated Reporter Training's which expire on 08/10/2025 and 07/26/2025 respectively. Licensee understands the training is mandatory to all Licensees and adults in the home in contact will children and requires renewal every two years.

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. LPA discussed the requirement for Licensee to be present at the facility 80 percent of the hours the facility is in operation and that temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. 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 a helper her license capacity is reduced to 8 and ratio (age of the children) must be observed.

LPA 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.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2024

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: KHUNKHUN, JASWANT	FACILITY NUMBER: 434415158
	VISIT DATE: 09/16/2024

NARRATIVE

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Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing updates and regulations.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. Licensee states that she is not administering any medications or IMS to children 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. 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.

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.

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 Technical violations was cited as a result of today's inspection. Exit interview conducted and report was reviewed with the licensee, Jaswant Khunkhun.

A 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.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2024

LIC809 (FAS) - (06/04)

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