434410139-4-6-2023-07-CC-ALOZ-CQMUTY-20230406155240

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410139
Report Date: 04/06/2023
Date Signed: 04/06/2023 03:53:12 PM

Document Has Been Signed on 04/06/2023 03:53 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:	DE PIEROLA, ERIKA		FACILITY NUMBER:	434410139
ADMINISTRATOR:	ERIKA DE PIEROLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 369-1806
CITY:	CAMPBELL	STATE: CA	ZIP CODE:	95008
CAPACITY:	14	CENSUS: 11	DATE:	04/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Erika De Pierola		TIME COMPLETED:	04:15 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 Analysts (LPAs) Ashley Lopez and Kassandra Medrano met with Erika De Pierola, for an unannounced Required – 1-year annual inspection. LPAs was granted access to the home by the Licensee and her husband, Carlos De Pierola. LPAs also observed 11 of children in the home during today's inspection. Licensee was operating within her capacity and ratio requirements. LPAs observed the required postings, including the facility license, near the front entrance to the home. Days and hours of operation are Monday - Friday from 7:30 AM - 6 PM. The adults residing in the home are: Licensee and Licensee's spouse, Carlos. LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on 1/7/23. Licensee states that she does not have liability insurance for the day care. LPAs observed affidavit's in all children's files. Licensee and her husband have current CPR and First Aid certifications, which expire 4/2/2024. Licensee and husband have the required vaccines and is current with her Mandated Reporter Training for Child Care Workers 4/2024. LPA reviewed 8 children's files and the files were complete with the required forms. LPAs toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home(408) 369-1806. The home is clean and orderly, and safe for the day care children. There are safe & age-appropriate toys, play equipment, and materials for the children in the home. There are no stairs inside or outside the home. LPAs observed a wall heater inside the home and is barricaded. Off limit areas inside the home: Bedroom #1, #2, and #4. Off limit areas outside the home: front yard and barricaded left side of backyard.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Ashley Lopez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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: DE PIEROLA, ERIKA	FACILITY NUMBER: 434410139
	VISIT DATE: 04/06/2023

NARRATIVE

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LPAs observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. The Licensee states that she does have 2 dogs who do not interact with the children and stay in off limit areas during day care hours. Licensee states there are no weapons in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Licensee states that she does administer any medications to the day care children upon request by parents. Licensee has a first aid kit in the home. Licensee states that nobody smokes, and she understands that smoking is prohibited in the home.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

Supervision of children was discussed with the Licensee and she 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/ratio options and she understands that she cannot have more than 14 children present in the home without two qualified adults present. Licensee states that a child will be isolated in the living room area if necessary due to illness or communicable disease. Licensee states that they do not transport any day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping. 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.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Ashley Lopez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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: DE PIEROLA, ERIKA	FACILITY NUMBER: 434410139
	VISIT DATE: 04/06/2023

NARRATIVE

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...A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPAs discussed the safe sleep regulations with the 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. LPAs also informed the 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.

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/process

Exit interview conducted and report was reviewed with the Licensee, Erika

No deficiencies issued during today's inspection. A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Ashley Lopez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

LIC809 (FAS) - (06/04)

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