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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417324
Report Date: 03/19/2025
Date Signed: 03/19/2025 01:36:05 PM

Document Has Been Signed on 03/19/2025 01:36 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:SALEEM, SAIMAFACILITY NUMBER:
434417324
ADMINISTRATOR/
DIRECTOR:		SALEEM, SAIMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 476-6667
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
03/19/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:08 AM
MET WITH:Saima SaleemTIME VISIT/
INSPECTION COMPLETED:
12:25 PM
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Licensing Program Analyst(LPA)Anna Morales conducted a POC(Plan of Correction) visit and was greeted by Licensee Saima Saleem and two preschool aged children.

On 3/5/25, LPA conducted an Annual Random inspection and the following TYPE B citations were issued:
1. 102417(g)(5)(A)- Cleared on 3/19/25.
2. 1596.814(a)(2)(A)- Cleared on 3/14/25-
3. 1596.814(a)(2)(B)- to be cleared on 4/2/25
4. 1596.814(a)(3)- Cleared on 3/5/25

During today's visit, LPA observed that the gate that was placed was at least five feet high and is constructed so that the gate/fence does not obscure the pool from view. The gate swings away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate.

LPA observed that there was a pool cover placed over the pool was locked. LPA, also, observed that the Licensee has been documenting and maintaining a daily inspection of the drowning prevention safety features and safety equipment before opening the facility.

The Licensee has submitted the PLAN OF CORRECTIONS(POC), and based on LPA's observation three of the Citations are cleared:
102417(g)(5)(A),1596.814(a)(2)(A), and 1596.814(a)(3).
No deficiencies are being cited at today's visit. Exit interview was conducted with Licensee Saima Saleem. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2025
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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