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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434401485
Report Date: 06/20/2023
Date Signed: 06/22/2023 12:57:05 PM


Document Has Been Signed on 06/22/2023 12:57 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:GARCIA, OLGAFACILITY NUMBER:
434401485
ADMINISTRATOR:GARCIA, OLGA & RANDOLPHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 655-4763
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY:14CENSUS: 0DATE:
06/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Olga GarciaTIME COMPLETED:
03:30 PM
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On 06/20/2023 at 2 pm, Licensing Program Analyst (LPA), Farida Raja, arrived to conduct an unannounced 1- year annual inspection. LPA was granted access to the home by Licensee, Olga Garcia and explained the nature of today’s inspection. Present in the home were licensee, licensee's spouse and 7 year old grandson. Licensee stated that she is not caring for daycare children at present and has not been since March 2020. Licensee plans to re-open in August, 2023. LPA conducted a Case Management Visit and toured the indoor and outdoor areas of the facility. Licensee stated that days and hours of operation will be Monday to Friday, 7:30 am to 5:00 pm. Licensee has current Pediatric CPR/ First Aid certification that expires on 08/28/2024 and a current Mandated Reporter Training that expires on 09/03/2024. LPA observed all required posted materials near the family room of the home. The adults that reside in the home are Licensee, spouse, daughter, son and grand daughter. Two minor children reside in the home. LPA observed a fully charged 3A40BC fire extinguisher in the dining room of the home.

Licensee will need to complete the following before enrolling children in August 2023:
  1. Obtain caregiver background checks and child abuse index clearances or exemptions for all adults residing in the home and all staff working with children.
  2. Store all detergents, cleaning compounds, medications, sharp objects including dog grooming kit and other similar items inaccessible to children.
  3. Place all gardening equipment/tools, fertilizers and pesticides inaccessible to children in locked storage shed outdoors.
  4. Barricade stairs to upper level.
  5. Have complete immunization's for all adults residing in the home and staff working/volunteering with children.
  6. Submit Incidental Medical Services Plan if caring for children with IMS needs.
Continued on Page 2
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:
DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/20/2023
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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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: GARCIA, OLGA
FACILITY NUMBER: 434401485
VISIT DATE: 06/20/2023
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LPA discussed the safe sleep regulations with Licensee, including documentation that shall be maintained and conducting 15-minute checks on all sleeping infants. LPA discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA provided licensee with a copy of an Individual Infant Sleeping Plan (LIC 9227) and a sample 15- minute sleeping infant check form.

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.

Exit interview conducted and report was reviewed with the Licensee, Olga Garcia. Licensee is advised to inform the San Jose Regional Office before enrolling any daycare children.

As a result of today's inspection, there were no deficiencies cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023
LIC809 (FAS) - (06/04)
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