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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434407129
Report Date: 03/09/2023
Date Signed: 03/09/2023 07:10:49 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/02/2023 and conducted by Evaluator Anna Morales
COMPLAINT CONTROL NUMBER: 07-CC-20230302095820
FACILITY NAME:TASHIRO, NARUMIFACILITY NUMBER:
434407129
ADMINISTRATOR:TASHIRO, NARUMIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 586-8711
CITY:SAN JOSESTATE: CAZIP CODE:
95132
CAPACITY:14CENSUS: 7DATE:
03/09/2023
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Tashiro NarumiTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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1. Facility is out of ratio
2. Licensee made infant sleep in a car seat
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Morales conducted an initial visit for the above allegations. LPA was met by Licensee Tashiro Narumi and discussed the above allegations.

Upon arrival approximately at 9:40am, LPA observed seven children (C1-C7 ) in care. C1-C3 are infants. Licensee was alone until assistant arrived at 10:00am.

Based on the interview, Licensee confirmed allowing children to sleep and stay in their car seat.
Based on LPA’s observations, records reviewed ( children's roster), and interview with licensee, the preponderance of evidence standard has been met. Therefore, the above allegations are SUBSTANTIATED. Deficiencies are being cited today.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED NEAR OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 07-CC-20230302095820
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: TASHIRO, NARUMI
FACILITY NUMBER: 434407129
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/10/2023
Section Cited
CCR
102416.5(a)
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102416.5 Staffing Ratio and Capacity:
The capacity specified on the Licensee shall be the maximum number of children for who care can be provided.
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The Licensee will submit a Plan on how she will be in capacity ratio compliance in the future by the POC date.
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This was not by: During today's visit, LPA observed 7 children (C1-C7) in care approximately at 9:40am. C1-C3 are infants. Licensee was alone until assistant(s) arrived at 10:00am. This poses an immediate, Health, Safety risk to the children in care.
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Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
Type A
03/10/2023
Section Cited
CCR
102425(h)
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Infant Safe Sleep 102425(h):Car seats shall only be used for transportation purposes and shall not be used for sleeping. This requirement is not met by:
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Licensee will submit a plan of how she will be in Infant Safe Sleep compliance in the future by the POC date.
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Based on interview, Licensee confirmed allowing children to sleep and stay in their car seats. This poses an immediate, Health, Safety risk to the children in care.
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Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
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: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3