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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416500
Report Date: 01/17/2023
Date Signed: 01/17/2023 04:00:29 PM

Document Has Been Signed on 01/17/2023 04:00 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:SHIRVANTE, DIVYAFACILITY NUMBER:
434416500
ADMINISTRATOR:DIVYA SHIRVANTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(669) 265-7546
CITY:SAN JOSESTATE: CAZIP CODE:
95131
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 5DATE:
01/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Divya ShirvanteTIME COMPLETED:
04:00 PM
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Licensing Program Analysts (LPAs) Cynthia Tamayo and Mel Matos met with Divya Shirvante, Licensee, for an unannounced Required – 1 year annual inspection. LPAs were granted access to the home by the Licensee. LPAs also observed five day care children (1 infant, 3 preschool, and Licensee's seven year old daughter) and one adult volunteer (Soni Kamath) present in the home during today's inspection. Licensee was operating within the capacity and ratio requirements of her license. LPAs observed the required postings, including the facility license, near the main entrance to the home. Days and hours of operation are Monday - Sunday from 7:00 AM - 10PM. The Licensee and her spouse (Nayak Preetham) are the adults residing in the home. Licensee's seven year old child also resides in the home.

LPAs reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/ and disaster drill was completed on October 11, 2022. Licensee states that she does not have liability insurance for the day care and issues the Affidavit Regarding Liability Insurance form (LIC 282) to all enrolled families. Licensee has current CPR and First Aid certifications. Licensee and adult volunteer has the required vaccines (MMR, Tdap, & flu) and are current with her Mandated Reporter Training for Child Care Workers. LPAs reviewed four children's files and the files were complete with the required forms and immunization records. LPAs reviewed two staff files (Licensee & adult volunteer) and the files were complete with the required forms and immunization records.

LPAs toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (669)265-7546. The home is clean, orderly, (including central heating/air conditioning/ventilation), and safe for the day care children. There are safe & age appropriate toys, play equipment, and materials for the children in the home. There are no open face heaters inside the home. LPAs observed barricaded stairs inside the home. The off limit areas inside the home (entire upstairs): three bedrooms and two bathrooms. Off limit areas inside the home (downstairs): attached garage and barricaded fireplace unit, located in the living room area. The off limit area outside the home: None. The off limit areas inside the home are inaccessible to children.

LPAs observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Licensee states there are no poisons in the home.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Cynthia Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: SHIRVANTE, DIVYA
FACILITY NUMBER: 434416500
VISIT DATE: 01/17/2023
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Licensee states that she provides all meals, including snacks (AM & PM) and lunch to the day care children. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored. Licensee has a first aid kit in the home which includes a touch less thermometer. Licensee understands that smoking is prohibited in the home.

Licensee states that she does not administer any medications to the day care children at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands the capacity/ratio options and she understands that she cannot have more than 14 children present in the home without at least two qualified adults present. Licensee states that a child will be isolated in the adjacent living room area if necessary due to illness or communicable disease. Licensee states that she does not currently transport any day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPAs discussed the safe sleep regulations with the 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. LPAs also informed the Licensee 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

Exit interview conducted and report was reviewed with the Licensee, Divya Shirvante. No deficiencies issued during today's inspection. Divya agreed to submit an updated Application for a Family Child Care License (LIC 279), copy of CPR/First Aid certifications, and Mandated Reporter Certificate by Friday January 20, 2023.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Cynthia Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2023
LIC809 (FAS) - (06/04)
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