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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417246
Report Date: 09/28/2026
Date Signed: 09/28/2026 05:07:21 PM

Document Has Been Signed on 09/28/2026 05:07 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:LEVEL UP MONTESSORI-SARATOGAFACILITY NUMBER:
434417246
ADMINISTRATOR/
DIRECTOR:		SAPNA RASTOGIFACILITY TYPE:
860
ADDRESS:12770 Saratoga AVETELEPHONE:
(408) 601-8209
CITY:SaratogaSTATE: CAZIP CODE:
95070
CAPACITY: 48TOTAL ENROLLED CHILDREN: 23CENSUS: 16DATE:
09/28/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Padma Srinivasaraman and Anu AgarwalTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
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On 09/28/2026, Licensing Program Analyst (LPA), Farida Raja and Regional Manager (RM), Juvenal Moctezuma, met with Director, Padma Srinivasaraman and Licensee Representative, Anu Agarwal for an unannounced annual inspection. The facility is licensed to serve 31 children ages 2-6 years in rooms 1 and 2 and 17 toddler component children ages 18-36 months in room 3 for a total of 48 children. This facility is located at a church site, Prince of Peace Lutheran Church. LPA observed the required posted materials in Room 1. Days and hours of operation are Monday through Friday, 8:15 AM to 5:30 PM. Facility has one waiver on file for sharing the outdoor area between preschool and toddler ages at alternating times. Entrance Checklist for Child Care Centers (LIC 125) was provided to Director during today’s inspection.

LPA, RM, Director and Licensee Representative toured the indoor and outdoor areas of the facility during today's inspection. LPA observed 11 preschool children, 5 toddler program children and 3 staff in Room 1. Children from the preschool and toddler program were observed to be combined for nap in Room 1. Per Director, Room 2 is not in use at this time. Facility was observed to be operating within the ratio and capacity requirements of the license but were observed to be commingling children from different programs. Director and Licensee Representative also explained that during drop offs both preschoolers and toddler program children are dropped off in Room 1 and immediately separated into their respective classrooms. RM explained that these two groups cannot be commingled at any time. Director and Licensee Representative stated that they will ensure that the groups will be separated during drop offs and nap time and no commingling of these two groups will occur throughout the day.

Classrooms, children's restrooms, diaper changing areas, staff restroom, and kitchen were inspected indoors. Facility has central heating and ventilation for comfort of children. LPA observed wall air conditioners in each classroom. Director states that there are no weapons or firearms on the premises.

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Gladys Kuizon
Farida Raja
DATE: 09/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2026
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.

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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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LEVEL UP MONTESSORI-SARATOGA
FACILITY NUMBER: 434417246
VISIT DATE: 09/28/2026
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There is a working telephone at the facility. Disinfectants, cleaning products and medicines were stored inaccessible to the children in care in child locked or high cabinets. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Floors in the facility are clean and safe. LPA observed solid waste containers with tight-fitting lids in the rooms. LPA observed appropriate changing tables in the restrooms and trash cans with tight fitting cover for the disposal of diapers. Napping equipment is appropriate. LPA inspected the napping equipment and observed them to be stored in a healthful manner. Restrooms and sinks for children were observed to be safe, sanitary, and in working condition. Urinals in the preschool bathroom were observed to be covered. Director and Licensee representative were informed to make those accessible as they were counted during capacity determination for the facility.

LPA observed serviced fire extinguishers, smoke and carbon monoxide detectors, and fire pull stations. The facility has a built-in smoke detector/ fire system. Log shows that the last fire Drill was conducted on 09/25/2026 which is compliant with the six-month requirement for facilities.

Drinking water is readily available for children in each room and in the outdoor playground area via individual water bottles and refilled using the water dispenser in Room 3. LPA observed water lead testing was completed by the facility prior to licensure on 01/11/2025 and an Action Level Exceedance was observed for the one faucet tested. Licensee Representative stated that the faucet was replaced and retested prior to licensure and will email the report of the retest to LPA by 10/09/2026. Licensee Representative stated that no faucets at the facility are used for drinking or food preparation purposes. The water dispenser is refilled using store bought water which is used to refill children's water cups.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test as specified in Health and Safety Code section 1597.16.

LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information)

Director provided LPA with a copy of the water lead report showing the exceedance, External Water Sampler Self Certification Form (LIC 9275), Child Care Center Sampling Checklist Form (LIC 9276) and facility sketch indicating the outlets tested during today's inspection.



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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LEVEL UP MONTESSORI-SARATOGA
FACILITY NUMBER: 434417246
VISIT DATE: 09/28/2026
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Parents provide lunch and snacks for the children. Parents have the option to purchase lunch as well. LPA observed a monthly menu. Facility provides dry snacks to the children. Food and beverages were stored safely to prevent contamination and spoilage. Food storage and preparation areas were observed to be sanitary. All food and beverages that require refrigeration are stored in covered containers.

Outdoor playground and play equipment were inspected. LPA observed play equipment was in good condition and age-appropriate. The playground area is surrounded by appropriate fencing and the outdoor surfaces are safe. Shade is provided by canopies and building overhang. There is a climbing structure in the playground with artificial grass as resilient material. As the age recommendation on the play structure is for children ages 2-12 years, Director and Licensee representative were informed to follow the age recommended by the manufacturer and prevent access to children under 2 years of age. No bodies of water were observed.

Children sign in and out procedures and logs were reviewed. Two children were not observed to be signed in today and two were signed in on the wrong date. Children's roster was reviewed, and a copy was provided to LPA. LPA reviewed a sample of five children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. Needs & Services Plans and 15-minute nap checks and logs are not being maintained for children under 24 months of age.

LPA discussed the safe sleep regulations with Licensee Representative and Director 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 Representative and Director of the importance of checking for and removing any 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.

Two staff files were reviewed. 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. The name of the child care center director or fully qualified teacher(s) designated to act in the director’s absence has been reported to the Department.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LEVEL UP MONTESSORI-SARATOGA
FACILITY NUMBER: 434417246
VISIT DATE: 09/28/2026
NARRATIVE
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Licensee Representative submitted a Designation of Facility Responsibility (LIC 308) form during today's inspection. Staff files reviewed contain the required transcripts/verification of experience, have current CPR and First Aid certification and Mandated Reporter Training's. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). All staff have the required immunization's against pertussis, measles and influenza or statement declining the influenza immunization.

Director provided an updated Personnel Report (LIC 500) form during today’s inspection. Director was reminded that all adults 18 and over, including employees and 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 Child Care Center. 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 the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations, Provider Information Notices (PINs), and Quarterly Updates.

LPA discussed Reporting Requirements as outlined in the regulations (Section 101212) and the availability of resources provided by the Technical Support Program.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/

Director to submit an Incidental Medical Services (IMS) plan to LPA by 10/09/2026. Medications at the facility are stored in high cabinets in Room 1 and are inaccessible to children in care. Isolation of sick child was discussed, and Licensee Representative explained that sick children will be isolated in the Youth Room, which is next to Room 1 and isolation equipment will be provided. Staff use a separate bathroom located in church premises that can be utilized by sick children if needed. Director understands that children shall be visually supervised at all times.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LEVEL UP MONTESSORI-SARATOGA
FACILITY NUMBER: 434417246
VISIT DATE: 09/28/2026
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Facility does not provide transportation to children. Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Per Title 22, Division 12, of the California Code of Regulations, one Type B deficiency and three technical violations were cited. Exit interview conducted and report was reviewed with Director, Padma Srinivasaraman and Licensee Representative, Anu Agarwal. Appeal rights provided.

NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

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 [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/inspection-process.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/28/2026 05:07 PM - It Cannot Be Edited


Created By: Farida Raja On 09/28/2026 at 04:21 PM
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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: LEVEL UP MONTESSORI-SARATOGA
FACILITY NUMBER: 434417246

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.4(a)(2)
(2) The toddler program shall be conducted in areas physically separate from those used by older or younger children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Based on interviews with Director and Licensee Representative, preschool and toddler program children are combined/commingled at drop off and during nap time in Room 1.
POC Due Date: 10/09/2026
Plan of Correction
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Director to submit a written plan of correction to LPA by plan of correction date of 10/09/2026.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Farida Raja
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2026


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