434409734-11-9-2023-07-CC-SCHN-CXF2AP-20231109161352

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434409734
Report Date: 10/30/2023
Date Signed: 11/09/2023 04:14:01 PM

Document Has Been Signed on 11/09/2023 04:14 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	THANG, NOEUN		FACILITY NUMBER:	434409734
ADMINISTRATOR:	NOEUN THANG		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 923-5850
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95116
CAPACITY:	14	CENSUS: 8	DATE:	10/30/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Noeun Thang		TIME COMPLETED:	05:00 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	Page 1. Licensing Program Analyst (LPA) Sheena Chin met with Licensee Noeun Thang, for an unannounced annual inspection. LPA explained the nature of today’s inspection to Licensee. Present during today’s inspection were the licensee, three assistants and 8 children in care in the facility. Days and hours of operation are Monday to Friday, 6am to 6pm. The adults that reside in the home are the licensee, her husband, her two sons and her nephew. The licensee owns the home. Observation LPA observed that required postings were posted. However, the posting location is not the place that parents dropped their kids. LPA advised the licensee to move the postings to the entrance so that parents are able to see the postings. LPA, along with the licensee toured the inside and outside of the home. The facility has a full charged fire extinguisher, 3A40BC. Carbon monoxide/smoke detectors are working properly. The off-limit areas inside in the home are living room, kitchen, all the 4 bedrooms and garage. The licensee did not have a fence or barrier between off-limit and on-limit. The licensee stated that she will not put anything toxic in the drawers or cabinet in the kitchen. All disinfectant, cleaning supplies, and other items that could pose a risk to children were observed to be inaccessible. LPA observed that there are toys for children. Fish food was observed in the cabinet under the fish tank, accessible to children in care. The licensee took away the fish food to the garage. LPA conducted CARE Tools for this annual inspection, which include Physical Plant, Care and Supervision, Facility Administration, Records, Staffing Ratio and Capacity, Personnel Rights for compliance with all licensing statutes, regulations, and interim licensing Standards, and results were documented on the tool. continue to page 2.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Sheena Chin	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: THANG, NOEUN	FACILITY NUMBER: 434409734
	VISIT DATE: 10/30/2023

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

Page 2.

Records review
The Licensee & her helper have current CPR and First Aid certifications expiring 05 /09/2025 . The Licensee and the helper both have child abuse training certificate, expiring 01/24/2024. LPA reviewed the fire and disaster drills log which is to be done at least once every six months. The last drills were conducted on 08/29/2023 .
LPA reviewed all 12 children files. Immunization records are maintained and updated in form PM 286. LPA observed Notification of Parents’ Rights is in each child’s file, and 15 min. sleeping check logs for infants under 2 years old.
During today’s inspection, all adults present or residing in the home have criminal record clearances required by the Department. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Discussion

Supervision of children was discussed with Licensee, who understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity options. Licensee states that she does not transport children via vehicle but she understands that children cannot be left in parked vehicles unattended at any time.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

continue to page 3.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Sheena Chin	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: THANG, NOEUN	FACILITY NUMBER: 434409734
	VISIT DATE: 10/30/2023

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

Page 3.

Discussions
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
The Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Deficiency
No deficiency was cited.

Further questions
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@dss.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/inspection-process.

Exit

During the exit interview, the Licensee, Noeun Thang, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Licensee, Noeun Thang.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Sheena Chin	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3