434409366-4-11-2023-07-CC-FRAA-CQSPCG-20230411111155

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434409366
Report Date: 04/07/2023
Date Signed: 04/11/2023 11:12:27 AM

Document Has Been Signed on 04/11/2023 11:12 AM - 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, LINDA		FACILITY NUMBER:	434409366
ADMINISTRATOR:	GARCIA, LINDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	4082708683
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95148
CAPACITY:	14	CENSUS: 6	DATE:	04/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:34 PM
MET WITH:	Linda Garcia		TIME COMPLETED:	03:30 PM

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	Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced 1- year annual inspection. LPA was granted access to the home by Licensee, Linda Garcia, and explained the nature of today’s inspection. Licensee arrived at 12:48pm after picking up school age children. Present during the inspection were the Licensee, one preschool child and 4 school aged children ages 3-17 years old. Another school age child arrived at 2pm. Licensee is presently caring only for grandchildren, nieces and nephew. Licensee was operating within the ratio and capacity requirements of her license. Days and hours of operation are Monday to Friday, 6:00 am to 6:00 pm. LPA observed all required posted materials near the front entrance to the home. The adults that reside in the home are Licensee, Licensee's mother- Mary Garcia and minor daughter. LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (408-270-8683). The home has central heating and ventilation for comfort of children. On limit areas inside the home are the living room, dining area, one bedroom and one bathroom. Licensee has a screened fireplace in the living room area. There are no stairs inside the home. Off limit areas outside the home: storage shed. There are no bodies of water. The back fence in the backyard has a broken slat. Licensee stated that its was because of the multiple rain events and the children have not used the backyard for several months. LPA advised licensee to fix damage before taking children to the backyard. LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors and a fire pull alarm. The Licensee states that she does not have any weapons. Licensee has one cat in the home. All detergents, cleaning compounds and medications are stored inaccessible to children. Licensee stated that she provides afternoon snack to the school age children in care. Continued on page 2

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 566-5850
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023

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 4

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, LINDA	FACILITY NUMBER: 434409366
	VISIT DATE: 04/07/2023

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

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Last fire/disaster drill was logged on 12/20/2022. LPA obtained copy of children's roster. Children file review was completed and found to be current and up to date. Five (5) children’s files were reviewed during today's inspection. Licensee does not care for any infants at present.

Staff file review was completed and found to be current and up to date. All individuals have clearances for Tuberculosis, Criminal Background, and Child Abuse Index Checks. Licensee does not have current Pediatric CPR/First Aid certification. Licensee has proof of immunization for measles, pertussis and influenza opt-out letter, according with the SB792. Licensee has current Mandated Reporter Training for Child Care Workers which expires on 12/09/2024. Licensee understands the training is mandatory to all Licensees and adults in the home in contact will children and requires renewal every two years.

Supervision of children was discussed with Licensee, and she understands that she or a qualified adult must be present in the home during day care hours and ensure that the children are supervised at all times. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time and a qualified assistant must be present. Licensee understands in absence of a helper her license capacity is reduced to 8 and ratio (age of the children) must be observed.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12-month period.

LPA discussed "zero tolerance" related regulations with licensee and advised her of the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

Continued on page 3

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 566-5850
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

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, LINDA	FACILITY NUMBER: 434409366
	VISIT DATE: 04/07/2023

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

Licensee states that she does not administer any medications to the day care children at this time. Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, a plan for providing IMS must be submitted to the Department. Licensee was provided the information regarding ADA: toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: http://www.ada.gov/childqanda.htm. Licensee is encouraged to visit the Department’s website at www.ccld.ca.gov to access resources for providers, regulations, adoptions of new laws, pay annual fees etc.
Licensee states that she transports children. LPA reminded Licensee that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dess.ca.gov. 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/process.

One Type B deficiency was cited today. Appeal rights were printed and given to Licensee.

Exit interview was conducted with licensee, Linda Garcia.

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

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 566-5850
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 04/11/2023 11:12 AM - 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: GARCIA, LINDA	FACILITY NUMBER: 434409366
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above. Licensee did not have a current CPR/First Aid training record on file which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/21/2023
	Plan of Correction
1 2 3 4	Licensee will complete pediatric CPR/First Aid Training and send proof of completion to LPA by Plan of Correction date of 04/21/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Kuizon	TELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 566-5850
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023

LIC809 (FAS) - (06/04)

Page: 4 of 4