434417447-3-5-2026-07-CC-MKAR-DRVVBV-20260305151810

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417447
Report Date: 03/05/2026
Date Signed: 03/05/2026 03:18:49 PM

Document Has Been Signed on 03/05/2026 03:18 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:	SHETTY, PRATHEEKSHA		FACILITY NUMBER:	434417447
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 6	DATE:	03/05/2026
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:02 PM
MET WITH:	Pratheeksha Shetty		TIME VISIT/ INSPECTION COMPLETED:	03:25 PM

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 March 05, 2026, Licensing Program Analyst (LPA) Mandeep Kaur conducted an unannounced Case Management-Licensee initiated Inspection in response to a capacity increase application. The application for capacity increase was submitted by Licensee on January 07, 2026. LPA met with Licensee, Pratheeksha Shetty, and explained to her the purpose of today's inspection. Per Licensee, there are two adults residing in the home: herself and her husband(A1). Licensee has one minor son, 5 year old, also residing in the home. Upon arrival, present were a Licensee's assistant(S1) and 6 children(3 infants and 3 preschool age) during today's inspection. Licensee is currently licensed for Small Family Child Care Home effective 01/23/2025. Fire Clearance for Large Family Child Care Home was granted on February 24, 2026. Days and hours of operation are Monday - Friday from 8:30 AM to 5:30 PM. Licensee submitted proof of completion in Health and Safety class including Nutrition and Lead Poisoning Prevention. Licensee's Mandated Reporter Training was completed on October 05, 2025. Licensee's immunizations in measles, pertussis, and flu are on file. Licensee has current Pediatric CPR/First Aid certifications expire on October 13, 2026. Licensee has current liability insurance on file that expires on January 02,2027 with Acord and Licensee understands that parents will need to fill out the Affidavit Regarding Liability Insurance (LIC 282) if she does not plan on obtaining liability insurance for the day care in the future. The licensee provided proof of control of property. Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). Continuation on next pages:

NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Mandeep Kaur
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026

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: SHETTY, PRATHEEKSHA	FACILITY NUMBER: 434417447
	VISIT DATE: 03/05/2026

NARRATIVE

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LPA toured the indoor and outdoor areas of the home during today's inspection. LPA observed barricaded
fireplace, barricaded kitchen, fully charged 3A40BC fire extinguisher, functioning smoke and carbon monoxide detectors. Off limit areas inside the home: Bedroom 2, one bathroom in a Bedroom 2, laundry room, and attached garage 1, garage 2 and garage 3. The home is clean and orderly, with heating/air conditioning, and ventilation for safety and comfort. There is sufficient toys, supplies, and equipment for the day care children. Licensee stated that there are no weapons and no pets in the home. Entire backyard is accessible to the children to play. LPA observed barricaded AC unit in the front left side of the home. There were no bodies of water observed.

Forms of discipline to be used by Licensee: talking to children and redirection. Cleaning products, toxic
agents, medications, and sharp objects were inaccessible to children. LPA reminded licensee that smoking,
baby walkers, bouncers, jumpers, and similar items are not allowed in Family Child Care Homes.

Licensee understands that children's personal rights should not be violated; including no corporal
punishment. Isolation of sick children, supervision of children, capacity options, transportation of children,
requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and
requirements for assistant/substitute were also discussed. The last fire drill was conducted on December 03.2025. LPA informed Licensee that fire/disaster drills must be practiced at least once every 6 months and documented.

Facility provides the food to the children. Healthy Beverage requirements were discussed and copy is provided to the Licensee. Licensee was advised to label the food containers and any water bottles those are brought from the children home, with children names.

Licensee, Pratheeksha Shetty, was reminded that all adults 18 and over living in the home, persons who provide 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 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.

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NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Mandeep Kaur
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026

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: SHETTY, PRATHEEKSHA	FACILITY NUMBER: 434417447
	VISIT DATE: 03/05/2026

NARRATIVE

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LPA discussed the requirements of Assembly Bill(AB) 633 with the Licensee. The Licensee understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed
"zero tolerance" related regulations with the Applicant and advised her of the assessment of an immediate
$500 civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100
per day continues until the violation(s) is corrected.

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 Applicant 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.

LPA reviewed with Licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes,
children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was
provided to the Licensee.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/.

On this date, March 04, 2026, the California Attorney General - Megan's Law website was searched for
information on sex offenders required to register with local law enforcement under California Megan's Law.
No registered sex offenders found at the facility addresses. Under state law, some registered sex offenders
are not subject to public disclosure; therefore, they may not have included in this search. However, the
Department conducts a monthly cross reference of each address on record for all registered sex offenders
against all CCLD facility addresses pursuant to information shared by California DOJ.

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NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Mandeep Kaur
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026

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: SHETTY, PRATHEEKSHA	FACILITY NUMBER: 434417447
	VISIT DATE: 03/05/2026

NARRATIVE

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Licensee was 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 platform. 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.

As a result of this inspection, a license for a Large Family Child Care Home for 14 children is granted effective March 6, 2026.

Exit interview conducted and report was reviewed with Licensee, Pratheeksha Shetty. Appeal rights were provided.

A notice of site visit was given and must remain posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Mandeep Kaur
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026

LIC809 (FAS) - (06/04)

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