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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409550
Report Date: 04/15/2024
Date Signed: 04/17/2024 08:47:25 AM

Document Has Been Signed on 04/17/2024 08:47 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:KARUMURI, ARUNAFACILITY NUMBER:
434409550
ADMINISTRATOR/
DIRECTOR:		KARUMURI, ARUNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 583-7974
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 9DATE:
04/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:52 AM
MET WITH:Aruna KarumuriTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 04/15/2024 at 8:52am, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced annual inspection. LPA was granted access to the home by Licensee, Aruna Karumuri and explained the nature of today’s inspection. Present in the home were licensee, assistant, and nine children including seven preschool age and two infants. Licensee was operating within the ratio and capacity requirements of the license. Days and hours of operation are Monday to Friday, 8:00 am to 6:00 pm. LPA observed all required posted materials near the front entrance to the home. Per Licensee, the adults that reside in the home are Licensee and spouse. Licensee stated that no minor children reside in the home.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (408-583-7974). LPA observed sufficient materials, toys, and play equipment for the day care children. The home has central heating/cooling and ventilation for comfort of children. The home is two story and LPA observed barricaded stairs during today's inspection. LPA observed a fireplace with a glass cover and child lock in the family room of the home. Off limit areas inside the home: entire upstairs, den, two storage closets, kitchen, super family room (as indicated on sketch) which is adjacent to the family room and attached garage. Licensee states that children use only the grass area and concrete area on the lower level of the backyard. The upper area, right and left side areas are not used by daycare children. Backyard is fenced and both sides of the home are gated. The outdoor space and play equipment were observed to be age appropriate and free of hazards. There are no bodies of water observed. Facility sketch indicates a pond in the backyard but LPA did not observe one and Licensee stated that the pond has been filled in. Licensee will submit an updated facility sketch to LPA indicating the on and off limit areas inside the home and updated yard sketch by 04/29/2024. LPA observed that the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. The shower area is free of any hazards.

LPA observed a fully charged 3A40BC fire extinguisher in the dining area and working smoke/carbon monoxide detectors. Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, poisons, medications, sharp objects and other similar items were observed to be stored inaccessible to children. Licensee understands that smoking is prohibited in the home.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2024
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: KARUMURI, ARUNA
FACILITY NUMBER: 434409550
VISIT DATE: 04/15/2024
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Drinking water is readily available for children in the home via individual water bottles. Licensee states that parents provide meals and snacks for the children. Licensee provides lunch in case parents do not provide it. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored or refrigerated. Licensee states that a child will be isolated in an area away from the other children if necessary due to illness or communicable disease.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was last conducted on 1/11/2024. LPA obtained copy of children's roster.

Seven (7) children’s files were reviewed during today's inspection. Licensee does not have liability insurance for the day care and issues the Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282). All children's files were complete with the required forms including 15-minute nap checks for infants.

LPA discussed the safe sleep regulations with licensee, including conducting 15-minute checks on all sleeping infants 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 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.

LPA reviewed two (2) staff files (Licensee and one assistant) for the required forms and found them to be current and up to date. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Licensee has current Pediatric CPR/First Aid certification which expires on 12/16/2025 and Mandated Reporter Training that expires on 02/20/2025. Licensee stated that assistant does not speak English and only speaks Hindi. Assistant is exempt from the requirement to complete the Mandated Reporter Training at this time. Licensee and staff have the required immunization in file for measles, pertussis and statement declining influenza. Licensee understand that the CPR/First Aid and Mandated Reporter Training needs to be renewed every two years and maintained.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024
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: KARUMURI, ARUNA
FACILITY NUMBER: 434409550
VISIT DATE: 04/15/2024
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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.

LPA discussed "zero tolerance" related regulations. A $500 immediate civil penalty is assessed for serious violations such as absence of supervision, accessible bodies of water, accessible firearms, refused entry of licensing staff, presence of an excluded person, and violations that result in illness or injury. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

Licensee is encouraged to visit the Department’s website at https://cdss.ca.gov/inforesources/child-care-licensing to access general updates, resources for providers, regulations, adoptions of new laws, pay annual fees etc. The Department will communicate all new information to providers through Provider Information Notices (PINs). Please sign up to be notified for new PINs at www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and visit the Department’s website for the latest PINs.

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. Licensee stated that no children require medication at this time. LPA provided a copy of PIN 22-02-CCP during today's inspection. 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/. Licensee states that she does not transport any day care children. During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. 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/inspection-process.

As a result of today's inspection, there were no deficiencies cited. Exit interview conducted and report was reviewed with the licensee, Aruna Karumuri.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024
LIC809 (FAS) - (06/04)
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