434412530-5-12-2023-07-CC-ALOZ-CRRMNV-20230512094610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412530
Report Date: 05/10/2023
Date Signed: 05/12/2023 09:46:20 AM

Document Has Been Signed on 05/12/2023 09:46 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:	LAFOSSE, MILAGROS		FACILITY NUMBER:	434412530
ADMINISTRATOR:	LAFOSSE, MILAGROS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 266-2524
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY:	14	CENSUS: 9	DATE:	05/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Milagros Lafosse		TIME COMPLETED:	11:30 AM

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) Ashley Lopez and Licensing Program Manager Joel Segura met with Milagros Lafosse, for an unannounced Required 1-year annual inspection. LPAs were granted access to the home by the Licensee. LPAs also observed 9 of children (4 infants, 5 preschool, and licensee's husband) 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 7:30AM to 6PM. The adults residing in the home are: Licensee and Licensee's spouse Martin. LPAs reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on 2/27/23. Licensee states that she does have liability insurance for the day care through Markel and LPAs observed a valid policy verifying coverage. Licensee and adult assistant have current CPR and First Aid certifications valid until 9/23/23. Licensee's husband asked for clarification of whether both he and licensee needed to keep CPR current, LPAs advised that at least one of them who have the certificate need to be present at all times when children in care. Licensee has the required vaccines and is current with her Mandated Reporter Training for Child Care Workers valid until 11/2024. Adult assistant also has the required vaccines and are current with his Mandated Reporter Training for Child Care Workers valid until 11/2024. LPAs reviewed 7 children's files and the files were complete with the required forms. LPAs reviewed 2 staff 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) 266-2524. 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 stairs inside the home that are barricaded by a gate. LPAs did not observe any wall heaters inside the home. Off limit areas inside the home: garage and second floor. Off limit area outside: 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: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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: LAFOSSE, MILAGROS	FACILITY NUMBER: 434412530
	VISIT DATE: 05/10/2023

NARRATIVE

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LPA 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. LPA 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 Milagros Lafosse.
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: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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: LAFOSSE, MILAGROS	FACILITY NUMBER: 434412530
	VISIT DATE: 05/10/2023

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LPAs observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. The Licensee husband states that they do have a dog that stays on the second floor when children are in care. Licensee states no weapons in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Licensee states that she does not administer any medications to the day care children. Licensee has a first aid kit in the home and does have a touchless thermometer. 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 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: http://www.ada.gov/childqanda.htm

Supervision of children was discussed with the Licensee, and they understand that they must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands their capacity/ratio options and they understand that they cannot have more than 14 children present in the home. 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 inquired about criminal record clearance for visitors, LPAs advised licensee that visitors will not need a clearance unless they are living in home more than 30 days. 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. 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.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Ashley Lopez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

LIC809 (FAS) - (06/04)

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