434413088-2-9-2023-07-CC-SCOS-CNW2JZ-20230209162709

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413088
Report Date: 02/08/2023
Date Signed: 02/09/2023 04:28:20 PM

Document Has Been Signed on 02/09/2023 04:28 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:	CHAIREZ-RAMIREZ, MICHELE		FACILITY NUMBER:	434413088
ADMINISTRATOR:	CHAIREZ-RAMIREZ, MICHELE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	4082349202
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95127
CAPACITY:	14	CENSUS:	DATE:	02/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:44 AM
MET WITH:	Michelle Chairez		TIME COMPLETED:	02:55 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), Stephanie Collins, conducted an unannounced annual inspection of the Family Child Care Home (FCCH). LPA met with Licensee Michelle Chairez and informed her the purpose of the visit. LPA arrived at the at the FCCH at 9:44 AM. Facility’s operating days and hours are Monday-Friday 07:00 AM to 05:30 PM. Present during the inspection was the licensee, her husband (Timothy Ramirez) and Assistant Michelle A. Chairez . LPA observed 11 children in care. All adults present are associated to the facility. Licensee Michele was reminded that all adults 18 and over, 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 Child Care Center. 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. LPA inspected the home inside and out. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Restroom for children to use were observed to be in operating conditions. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were stored inaccessible. LPA observed that food storage areas were clean, free of litter, rubbish, and rodents/vermin. Foods and beverages were kept protected against contamination and spoilage. Trash cans for solid waste had tight-fitting covers on.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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: CHAIREZ-RAMIREZ, MICHELE	FACILITY NUMBER: 434413088
	VISIT DATE: 02/08/2023

NARRATIVE

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LPA observed backyard is fully fenced in and play equipment is maintained in a good condition, free of hazards. There were no bodies of water observed. Licensee states there are no weapons on the premises. Drinking water is arranged to be readily available to children.
Log recorded that the last fire/disaster drill was conducted on (12/2022). LPA reviewed Family Child Care Home Roster.

At 11: 20 AM LPA reviewed eleven children’s file. Children records reviewed includes: Identification and Emergency Information, Consent for Emergency Medical Treatment form, Notification of Parents’ Rights and Affidavits regarding liability insurance, Parent Notification of additional children in care and immunization. LPA observed C1, C2, C3, C5, C6,C7, C8,C10, missing LIC 282 Affidavits Regarding liability insurance.

At 12:10 PM LPA reviewed Personnel Records reviewed include: Criminal Record and Child Abuse Index Background Check Clearance, Health Screening Report with TB Clearance, Immunization Record for Measles and Pertussis, Mandated Reporter and CPR/First Aid. Licensee CPR/First Exp Date 2/3/2024.

LPA reminded licensee that the AB1207 Mandated Reporter Training needs to be renewed every two years. There was at least one person with documented current certification in Pediatric CPR/1st Aid present at the facility during LPA' inspection.
This facility provides Incidental Medical Services – currently the facility does not have any children in care who requires IMS. 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.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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: CHAIREZ-RAMIREZ, MICHELE	FACILITY NUMBER: 434413088
	VISIT DATE: 02/08/2023

NARRATIVE

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LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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

LPA reviewed with the violations that would result in an immediate $500 civil penalty assessment. Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov [Shortcut: ccld.ca.gov] to access resources for Providers, Regulations etc.
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.

In the areas that were evaluated, regulatory violations were observed at the time of the inspection.

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

Exit interview conducted and report was reviewed with the licensee Michele Chairez- Ramirez

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/09/2023 04:28 PM - 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: CHAIREZ-RAMIREZ, MICHELE	FACILITY NUMBER: 434413088
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)

Alicensed child day care provider administrator, or employee of a licensed child day care facility shall completed the mandated reporter training [...] and shall complete renewal madted reporter training every two years following ter the date on which he or she completed the initial mandated reporter traing. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on) record review), the licensee did not comply with the section cited above in 1 out of [1} which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/10/2023
	Plan of Correction
1 2 3 4	Licensee agreed to submit proof of Mandated Reporter Training for Licensee Michele Chairez-Ramirez and Assistant Michelle Chairez on or before POD date.

Type B

Section Cited

CCR

10241(m)(3)

A file of affidavits signed by each parent with a child enrolled in the home . [...] This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review)], the licensee did not comply with the section cited above in [1] out of [1] ] which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/10/2023
	Plan of Correction
1 2 3 4	Licensee agrees to submit the LIC 282 Affidavits Regarding Liablility insurance for C1- C11. by or before POC date

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) 566-5850
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

LIC809 (FAS) - (06/04)

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