<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408377
Report Date: 11/15/2023
Date Signed: 11/16/2023 09:07:38 AM

Document Has Been Signed on 11/16/2023 09:07 AM - 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:AFJEI, BATOOL & GHOREYSHI, SEYEDFACILITY NUMBER:
434408377
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 4DATE:
11/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Batool AfjeiTIME COMPLETED:
03:20 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 11/15/2023 at 2:20pm, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced case management inspection as a result of an informal office meeting conducted with Licensees, Batool Afjei and Seyed Ghoreyshi on 09/28/2023. LPA met with licensee, Batool Afjei and explained the nature of today's inspection.

LPA toured the indoor and outdoor areas and observed licensee and 4 infant children during today’s inspection. Licensee is operating within the ratio and capacity requirements of the license. Children were napping in cribs in the family room during today's inspection. LPA observed that licensee is providing care in the family room of the home. LPA reviewed licensee, Batool's immunization's, cleared deficiency and provided a copy of the letter of deficiency citations cleared during today's visit. LPA reviewed four children's files and observed 15 minute nap check log and LIC 9224 in each child's file. LPA observed that the swimming pool in the backyard is fenced and gated and LPA observed the mesh installed between panels to fill gaps.

No deficiencies were cited as result of today's inspection. Exit interview was conducted and report was reviewed with Licensee, Batool Afjei..

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2023
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 1