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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409531
Report Date: 10/19/2022
Date Signed: 10/19/2022 07:55:34 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/19/2022 07:55 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:JAIN, SHUBHRAFACILITY NUMBER:
434409531
ADMINISTRATOR:JAIN, SHUBHRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 272-2859
CITY:SAN JOSESTATE: CAZIP CODE:
95132
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:16 PM
MET WITH:Kumar Bharat TIME COMPLETED:
01:45 PM
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On 10/19/2022 LPA attempted annual inspection. LPA was met at door by a person who identified himself as the Husband (Kumar Bharat) of the licensee. LPA was allowed to enter the home and observed there were no children present. He stated due to medical issues her wife chose to close the day-care. LPA asked if they are closing the day care or would like to go In-active status and explained what in-active status was. . The Husband stated because our fees are current, we are not sure if we would like to permanently close or not , so he decided they would like to go IN-ACTIVE. LPA informed the husband the Licensee (Jain Shubhra) would need to submit an LIC 9211 REQUEST FOR INACTIVE CHILD CARE LICENSE STATUS. Licensee's husband agreed to follow through with his wife. he gave the e-mail adress as: [email protected]
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2022
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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