430756119-12-2-2019-07-CC-DMAC-BJGR3A-20191202113937

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430756119
Report Date: 12/02/2019
Date Signed: 12/02/2019 11:39:44 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	GUIDOTTI, SHARRON		FACILITY NUMBER:	430756119
ADMINISTRATOR:	GUIDOTTI, SHARRON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 265-1068
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95136
CAPACITY:	14	CENSUS: 5	DATE:	12/02/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Sharon Guidotti		TIME COMPLETED:	11:50 AM

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	LPA met with Sharon Guidotti, Licensee, and explained the purpose of today’s inspection. LPA observed two Assistants Vijayathus Kandasamy and Monica Herrera, and five daycare children of whom were one infant and four preschoolers during today's inspection. Assistant Monica Herrera left at 9:46am. Days and hours of operation are: Monday-Friday 8:30am-5:00pm. LPA toured the home both inside and out. Off limit areas are master bedroom, office, kitchen, laundry, and garage. Backyard and sides of the home are fenced and used for outdoor activity. LPA observed that there are no bodies of water. LPA observed a fully charged 2A10BC fire extinguisher, working smoke detector and carbon monoxide. Licensee stated that there are no weapons in the home. Cleaning products, toxic, medications, and sharp objects were inaccessible to children. The home is clean, orderly, and safe for the day care children. LPA observed sufficient materials, toys, and play equipment for the day care children. Licensee stated that she does not transport children. The last fire/disaster drill was conducted on 10/29/19. LPA reviewed the Child Care Facility Roster. Five children's files were reviewed and all were complete. Licensee stated she does not have any children in care who requires administration of medication. The facility is not providing Incidental Medical Services at this time. IMS was discussed. The following US Department of Justice resource was provided: http://www.ada.gov/childqanda.htm. Continued on Page #2

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2019

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 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GUIDOTTI, SHARRON	FACILITY NUMBER: 430756119
	VISIT DATE: 12/02/2019

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
26
27
28
29
30
31
32

Continued from Page #1

Licensee and Assistants' files maintain records of immunizations. Licensee's Pediatric CPR & First Aid certification expires 09/03/2020. Licensee's Mandated Report training expires 5/30/2020. LPA reminded Licensee that the Mandated Reporter Training needs to be renewed every two years. Licensee was provided the Mandated Reporter Training website http://mandatedreporterca.com. Licensee's Assistants' files were reviewed. Assistant Monica Herrera will complete the Mandated Reporter Training by the end of January 2020.

Adults who reside in the home are Licensee, Licensee's spouse, and Licensee's daughter. They have Clearances for Tuberculosis, and Criminal Background and Child Abuse Index Checks. LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children.

Licensee's spouse requested to be added to the license. Licensee's spouse file was reviewed which included a proof of orientation, records of immunizations, First Aid/CPR certificates expires 11/02/2021, and Mandated Reporter Training expires 5/30/2020.

LPA provided a copy of the “Lead Poisoning Facts Information Flyer”, "Car Seat Law", and "Safe Sleep" Information to Licensee. Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing updates and regulations.

No deficiency was cited today. An exit interview was conducted. Notice of Site Visit was given to Licensee and must remain posted for 30 days.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2