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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700750
Report Date: 07/15/2025
Date Signed: 07/15/2025 11:50:51 AM

Document Has Been Signed on 07/15/2025 11:50 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:BUILDING KIDZ OF MILPITAS AT MAIN STREETFACILITY NUMBER:
435700750
ADMINISTRATOR/
DIRECTOR:		JAIN, SAPNAFACILITY TYPE:
850
ADDRESS:195 NORTH MAIN STREETTELEPHONE:
(408) 425-6434
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 26TOTAL ENROLLED CHILDREN: 26CENSUS: 8DATE:
07/15/2025
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Licensee / Director Sapna JainTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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On 7/15/2025 at 9:30 AM Licensing Program Analyst (LPA) Manel Estoesta conducted a Case Management visit. LPA met with the Licensee / Director Sapna Jain and explained the nature of the visit. Present on this visit were 2 Staff and 8 Preschool Children.

The facility operates from Monday to Friday, 8:30 AM to 5:30 PM.

LPA discussed the PIN 21-21.1-CCP. As per section 101700.3, which states in subsection (b)(1), A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance (ALE).

The department was notified that the facility had elevated lead levels that had exceeded 5.5 ppb. This exceeded the ALE established by the state for lead exposure. Facility’s sample site ID “D” from the outdoor play area, had tested for ALE, with a laboratory sample date of 5/20/2025 and laboratory analysis date of 5/29/2025. The License received an email notification of ALE result on 6/11/2025. The facility ceases the use of the water outlet that had an ALE. The facility immediately ceases until it is replaced and retested. LPA reminded Sapna that if the outlet returns an ALE result, an alternative water source shall be provided before care is provided at the facility.

LPA Estoesta informed Sapna that this report dated 7/15/2025 included a Type B Citation which can be posted as there is a potential risk to the health, safety, and or personal rights of children in care.

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

Appeal rights provided.

Exit interview was conducted with the Licensee / Director Sapna Jain.

NAME OF LICENSING PROGRAM MANAGER: Jason Jang
NAME OF LICENSING PROGRAM ANALYST: Manel Estoesta
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2025
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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Document Has Been Signed on 07/15/2025 11:50 AM - It Cannot Be Edited


Created By: Manel Estoesta On 07/15/2025 at 11:09 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: BUILDING KIDZ OF MILPITAS AT MAIN STREET
FACILITY NUMBER: 435700750

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/15/2025
Section Cited

101700.3(b)(1)

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Section 101700.3, which states in subsection (b)(1), A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance (ALE)....
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The facility immediately ceases the use of the outlet for drinking and food preparation that had ALE result. The Licensee will request for replacement and retesting on or before the Plan of Correction (POC) due date. Also LPA informed the Licensee to send notification to all parents or guardians, that includes what steps licensee will take on this POC.
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This requirement is not met as evidenced by, facility’s sample site ID “D” from the outdoor play area, had tested for ALE, with a laboratory sample date of 5/20/2025 and laboratory analysis date of 5/29/2025 which is a potential risk to the health, safety, and or personal rights of children in care.
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LPA discussed to the Licensee the PIN 21-21.1-CCP (Supersedes PIN 21-21-CCP) WRITTEN DIRECTIVES FOR LEAD TESTING OF WATER IN LICENSED CHILD CARE CENTERS PURSUANT TO AB 2370 CHAPTER 676, STATUTES OF 2018.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Jason Jang
NAME OF LICENSING PROGRAM MANAGER:
Manel Estoesta
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2025


LIC809 (FAS) - (06/04)
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