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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417222
Report Date: 07/21/2025
Date Signed: 07/21/2025 03:12:19 PM

Document Has Been Signed on 07/21/2025 03:12 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:3D PRESCHOOLFACILITY NUMBER:
434417222
ADMINISTRATOR/
DIRECTOR:		MEENAKSHI, NIRMALAFACILITY TYPE:
860
ADDRESS:5370 SNELL AVENUETELEPHONE:
(408) 227-2840
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY: 93TOTAL ENROLLED CHILDREN: 93CENSUS: 39DATE:
07/21/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Nirmala KumaranTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Andy Yang and Mandeep Kaur, and Licensing Program Manager (LPM), Belinda Devall met with Site Director, Nirmala Meenakshi, and Licensee Representative, Meenakshi Gokhali, for the purpose of conducting a Case Management - Licensee Initiated Inspection. The facility submitted an application to change the preschool and toddler capacity from 93 (51 preschoolers & 42 toddlers) to 93 children (85 preschoolers and 8 toddlers). Fire clearance was approved on 7/14/2025. Present for today's inspection were Director, Licensee Representative, (9) teachers and (39) children (preschool age) and no toddlers. The school operates a toddler component with single license.

The facility is currently licensed with 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 are Monday to Friday 7:30AM to 6:00PM. The updated application is requesting to convert the toddler Fellowship hall and outdoor play area attached to the room for preschool children. LPAs and LPM toured the facility during today's inspection as well as measured the space available for the children. LPAs and LPM inspected the toddler Fellowship hall and observed (10) preschool children who are not enrolled into the toddler program, (2) teachers and (1) aide. LPA Yang reminded the director shall not operate a child care center beyond the conditions and limitations specified on the license.

Preschool Classrooms measurements are:

The Indoor total measurements contain a total of {3042.95} square feet, which will accommodate Applicant's request for 85 preschool children.

Preschool Outdoor Play measurements are:

Outdoor total measurements contain a total of {7246.55} square feet, which will accommodate Applicant’s request for 85 preschool children.

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NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Andy Yang
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
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: 07/21/2025
NARRATIVE
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***Page 2***

Toddler Classroom measurements are:

The Indoor total measurements contain a total of {235.75} square feet, which will accommodate 6 toddlers, and will not accommodate applicant's request of 8 toddlers.

Toddler Outdoor Play measurements are:

Outdoor total measurements contain a total of {1573.8} square feet, which will accommodate 6 toddlers per indoor capacity measurement.

Total measurement capacity is 91 children (85 preschool and 6 toddlers), which does not meet the applicant's request of 93 children (85 preschool and 8 toddlers). An updated Application for Child Care Center License (LIC 200A) is needed to reflect the updated capacity measurements and the type of business entity of the facility. During the inspection, an updated LIC 200A is provided with all the requirements.

Toddlers may be enrolled into the program starting at age 18 months to a maximum of 36 months with written permission from the child's authorized representative. 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. Toddlers shall be escorted by staff to the toddler playground, while transitioning from the classroom through the preschool playground.


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 as well as teacher-child ratio 1:6. 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 provides AM/PM snacks and lunch to children in care.



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NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Andy Yang
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 07/21/2025 03:12 PM - It Cannot Be Edited


Created By: Andy Yang On 07/21/2025 at 12:23 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: 3D PRESCHOOL
FACILITY NUMBER: 434417222

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2025
Section Cited
CCR
101161(a)

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(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

The requirement is not met as evidence by:
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Plan of Correction was cleared during today's visit.
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Based on observation, and interview, the facility utilizes the todder Fellowship room for preschool age, which poses a potential risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Belinda Devall
NAME OF LICENSING PROGRAM MANAGER:
Andy Yang
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2025


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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: 3D PRESCHOOL
FACILITY NUMBER: 434417222
VISIT DATE: 07/21/2025
NARRATIVE
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***Page 3***

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 8 toilets, 7 sinks, 1 urinals, available for preschool and toddler children. There are ample tables, chairs, and cots to meet the needs of children in care.

The isolation area for the sick children is the facility office (room 106). Bathroom for sick children and staff is the men's bathroom located in the front of the facility.

One (1) Type B deficiency was issued and cleared during today's inspection.

Type B

  • Facility is operating beyond the conditions and limitations specified on the license for the toddler Fellowship room. Appeal rights provided.

Change in capacity Application is approved by LPM as of 7/21/2025.

A notice was site visit was issued and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Director, Nirmala Meenakshi, and Licensee Representative, Meenakshi Gokhali
NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Andy Yang
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5