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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 270709833
Report Date: 06/13/2023
Date Signed: 06/13/2023 02:33:42 PM


Document Has Been Signed on 06/13/2023 02:33 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:MISS BARBARA'S CHILD CARE CENTERFACILITY NUMBER:
270709833
ADMINISTRATOR:CHRISTINE AIELLOFACILITY TYPE:
850
ADDRESS:226 BEACH ROADTELEPHONE:
(831) 883-2616
CITY:MARINASTATE: CAZIP CODE:
93933
CAPACITY:48CENSUS: 23DATE:
06/13/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:John MimsTIME COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Joe Macias conducted an unannounced Case Management Inspection. The purpose of today’s visit is to ensure the facility is in compliance with Title 22 California Code of Regulations. LPA met with the Administrator John Mims, and explained the nature of today's visit.

The LPA issued an order to the facility of the immediate exclusion of the current Director Christine Aiello from the facility. The Department has determined Christine Aiello's continued or future contact with clients or presence in any facility licensed by CDSS constitutes a threat to the health and safety of the children in care. All families receiving services should be notified of the action taken by the Department.

LPA Macias reviewed the importance of adhering to the order issued.

The facility remains out of compliance, as there is no documentation of who is currently designated as the responsible party for the License. Based on interviews with Barbara Moore and John Mims there has been a verbal agreement of partnership. Resulting in John Mims retaining the majority of the business. However the Department has not received any documents supporting the sale and or partnership. The LPA has requested the Administrator John Mims and the Owner Barbara Moore submit all required licensing documents supporting any changes made to the license.

Type A deficiency cited, exit interview conducted and copy of this report provided to the Administrator John Mims.

LPA discussed the requirements of AB633 with the Director and provided the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224), the Director understands the requirements.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE CENTER, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2023
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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Document Has Been Signed on 06/13/2023 02:33 PM - It Cannot Be Edited

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: MISS BARBARA'S CHILD CARE CENTER
FACILITY NUMBER: 270709833

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/14/2023
Section Cited
CCR
101212

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Reporting Requirements:
The items below shall be reported to the Department within 10 working days following their occurrence:
Any change of the chief executive officer of a corporation, of the general partner(s) of a partnership, or of the controlling partners in a limited liability corporation.
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Administrator John Mims and the Owner Barbara Moore shall submit all required licensing documents supporting any changes made to the license by the POC date.
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The facility remains out of compliance, as there is no documentation of who is currently designated as the responsible party for the License. Based on interviews with Barbara Moore and John Mims there has been a verbal agreement of partnership. Resulting in John Mims retaining the majority of the business. This poses an immediate risk to the health, safety, and personal rights of the children in care.
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AB633 to issued to all parents of children in care, signed, filed in each child's file, and provider to do the same for all new clients for the next 12 months to this day.

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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.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2023
LIC809 (FAS) - (06/04)
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