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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417222
Report Date: 05/20/2025
Date Signed: 05/20/2025 11:34:28 AM

Document Has Been Signed on 05/20/2025 11:34 AM - 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:3D PRESCHOOLFACILITY NUMBER:
434417222
ADMINISTRATOR/
DIRECTOR:		MEENAKSHI, NIRMALAFACILITY TYPE:
860
ADDRESS:5370 SNELL AVENUETELEPHONE:
(408) 227-2840
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY: 102TOTAL ENROLLED CHILDREN: 102CENSUS: 85DATE:
05/20/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:01 AM
MET WITH:Nirmala KumaranTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 05/20/2025, Licensing Program Analyst (LPA), Harsimran Kaur conducted an unannounced pre-licensing inspection and met with Nirmala Kumaran, Applicant Representative. The purpose of the visit was an unannounced pre-licensing inspection to add a toddler component. The facility has an existing preschool program facility #434411608 with a capacity of 102 preschool children which will be converted to a single license upon completion of the inspection process. Applicant is requesting to be licensed for total 93 children from which 51 preschoolers (ages 2 years to entry to first grade) in preschool classroom 103/104/105 and Bldg C. 42 toddlers (ages 18-36 months) in toddler classroom fellowship hall and nursery #102. Hours of operation will be Monday to Friday 7:30AM to 6:00PM. Fire clearance was granted on 04/03/2025.
Preschool Classrooms measurements are:

The Indoor total measurements contain a total of {1795.84} square feet, which will accommodate Applicant's request for 51 preschool children.

Preschool Outdoor Play measurements are:

Outdoor total measurements contain a total of {4836.12} square feet, which will accommodate Applicant’s request for 51 preschool children.

Toddler Classroom measurements are:

The Indoor total measurements contain a total of {1482.86} square feet, which will accommodate Applicant's request for 42 toddlers.

Toddler Outdoor Play measurements are:

Outdoor total measurements contain a total of {3619.78} square feet, which will accommodate Applicant’s request for 42 toddler.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Harsimran Kaur
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2025
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: 3D PRESCHOOL
FACILITY NUMBER: 434417222
VISIT DATE: 05/20/2025
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All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Applicant that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. A fully equipped first aid kit is located in all classrooms. There is an operational carbon monoxide detector on site. All required licensing documents were observed posted near the facility office.
LPA continued to tour the facility and measured all indoor and outdoor activity space.

The facility was observed to be clean, safe, sanitary and in good repair to ensure the safety and well-being of children, employees and visitors. A comfortable temperature for children shall be maintained at all times. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. There are 108 chairs, 20 tables, 148 cubbies, 9 toilets, 9 sinks, 2 urinals, 92 cots, available for preschool and toddler children.

The facility currently has a fully fenced playground and separate area for preschool and toddlers. Fencing is at least four feet high. Shade is provided via canopies. There are sufficient outdoor age-appropriate toys and play equipment available on the playgrounds. There are age appropriate climbing structures on the preschool yard. There is adequate cushioning in fall zones. children take their own water bottle outside in playyard. LPA observed all hazardous items on the playground(s) to be inaccessible to children. Applicant was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.



LPA reviewed with Applicants Section 101216.4 Preschool Program with Toddler Component. Toddlers may be enrolled into the program starting at age 18 months to a maximum of 36 months. LPA advised that children enrolled into the toddler program cannot be placed in the preschool program before the age of thirty (30) months without the written permission from the child's authorized representatives. LPA additionally advised that the toddler program shall be conducted in areas physically separated from those used by the preschool program and commingling shall not be permitted between components.

LPA advised that toddlers enrolled into the toddler component shall follow infant regulations, including nap check documentation and Infant Safe Sleep requirements, until they turn twenty four (24) months of age.
LPA advised Applicants that the following first-aid supplies in a location accessible to staff but inaccessible to children: current edition of a first-aid manual, sterile first-aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometer, and antiseptic solution. Facility provide 2 snacks and lunch to their children. The isolation area for children who are ill will be the at the facility office
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Harsimran Kaur
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: 3D PRESCHOOL
FACILITY NUMBER: 434417222
VISIT DATE: 05/20/2025
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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).

Applicants were reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.
This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes 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) or (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
LPA discussed the safe sleep regulations with Applicants 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 Applicants 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.
Applicants were informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
Exit interview was conducted and copy of appeal rights were provided to Nirmala Kumaran, Applicant Representative. Final license determination for a single license will be made upon review by the Licensing Program Manager.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Harsimran Kaur
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
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