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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417113
Report Date: 10/29/2025
Date Signed: 10/29/2025 04:35:41 PM

Document Has Been Signed on 10/29/2025 04:35 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:LAUREL PLAY GARDENSFACILITY NUMBER:
434417113
ADMINISTRATOR/
DIRECTOR:		SMITABEN MISTRYFACILITY TYPE:
830
ADDRESS:1050 PARK AVENUETELEPHONE:
(408) 645-5783
CITY:SAN JOSESTATE: CAZIP CODE:
95126
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 7DATE:
10/29/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Aakriti Beri, LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
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Licensing Program Analysts (LPA), Liridon Fici-Doni, met with Aakriti Beri, Licensee for an unannounced Required 1 Year Inspection. LPA was granted access to the facility-by-facility staff and toured both indoors and outdoors during the inspection with Licensee. Upon arrival, there were seven (7) infants, and three (3) staff present, which is compliant with the facility license capacity and ratio requirements; a review of children roster indicated no children are over 2 years of age. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 7:00AM-6:00PM. Shortly after, Director Smitaben Mistry joined LPA and the Licensee for the tour.

(Type of app. used) LPA reviewed digital sign-in/out sheets on bright wheel, the facility roster (LIC9040), and the fire/disaster drill log during today’s inspection. The last fire/disaster drill was conducted on 9/29/2025, which is compliant with the six-month requirement for facilities. LPA observed a fully charged 2A10BC fire extinguisher, with functioning smoke detector and carbon monoxide detector. There are no weapons or firearms on the premises. LPA did not observe any bodies of water during inspection.

Three (3) staff files were reviewed, and LPA advised that infant staff shall have three (3) units related to the care of infants. There is at least one staff member with current First-Aid/CPR and all staff should have a mandated Reporter certificate on file in the center. LPA reminded that both shall be updated every two years.

This annual will continue on a different date. A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Smitaben Mistr along with appeal rights.
NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Liridon Fici
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2025
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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Document Has Been Signed on 10/29/2025 04:35 PM - It Cannot Be Edited


Created By: Liridon Fici On 10/29/2025 at 03:27 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: LAUREL PLAY GARDENS
FACILITY NUMBER: 434417113

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101439.1(b)
Infant Care Center Sleeping Equipment
(b) A crib or portable -crib meeting United States Consumer Product Safety Commission safety standards shall be provided for each infant who is unable to climb out of a crib.

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 by allowing Child 1- C1 that is 6 months old to sleep on a bean bag with a blanket on the child which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/05/2025
Plan of Correction
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Licensee removed the child from the bean bag and placed the child in a crib. Licensee agreed to not allow any infants to sleep on the floor without a crib. LPA also will have the Licensee submit a self-certification on section 101439.1 Infant Care Center Sleeping Equipment which ackowledges the regulation and to sign, date, and submit to CCL by POC due date.
Type B
Section Cited
CCR
101416.5(b)
Staff-Infant Ratio
(b) There shall be a ratio of one teacher for every four infants in attendance.

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 by not having a qualified teacher caring for infants; LPA observed 5 infant children during visit with an aide which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/05/2025
Plan of Correction
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Licensee agreed to ensure staff are qualified to care for infant children during operation hours. Licensee agreed to have one room for infants and have a qualified staff and aide with 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:
Liridon Fici
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/29/2025


LIC809 (FAS) - (06/04)
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