434413670-12-2-2022-07-CC-SCOS-CLQVKQ-20221202153044

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413670
Report Date: 12/02/2022
Date Signed: 12/02/2022 03:30:59 PM

Document Has Been Signed on 12/02/2022 03:30 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:	LARA-RAMIREZ, ROSIE		FACILITY NUMBER:	434413670
ADMINISTRATOR:	LARA, ROSIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	4082097040
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95127
CAPACITY:	14	CENSUS:	DATE:	12/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:23 AM
MET WITH:	Lara-Ramirez Rosie		TIME COMPLETED:	12:24 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. LPA met with Licensee Lara-Ramirez Rosie and informed her the purpose of the visit to conduct an Annual Inspection. LPA arrived at the facility at 8:15 AM, Notification of Parents’ Right Poster, Child Care License, LIC 610 Emergency Disaster Form (1and 2), and menu were observed to be posted. Facility’s operating days and hours are Monday-Friday 08:00 AM - 05:00 PM. During visit, LPA observed 4 children the licensee and assistant Esmeralda Romo. Residing in the home is the Licensee, her husband (Brian Ramirez) her mother Inz Lara and their two children. Licensee Lara-Ramiriz,Rosie 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.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

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

Document Has Been Signed on 12/02/2022 03:30 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: LARA-RAMIREZ, ROSIE	FACILITY NUMBER: 434413670
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/02/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. 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] Lara-Ramirez Rosie which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/19/2022
	Plan of Correction
1 2 3 4	Licensee agreed to submit Proof of Mandated Reported Training on or before POC date.

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) 566-5850
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

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: LARA-RAMIREZ, ROSIE	FACILITY NUMBER: 434413670
	VISIT DATE: 12/02/2022

NARRATIVE

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LPA inspected the home inside and out with licensee Rosie Lara-Ramirez. The home has a functioning carbon monoxide, Smoke detector and fully charged fire (3-A-40-BC).Medication, cleaning products and similar items that can pose a danger to children if readily accessible are stored inaccessible to children.

off limit areas of the home are as follows: Garage, entire upstairs and 3 downstairs bedrooms in the rear of the home. There are two room lower level available for infants napping. Home has one dog, per Licensee the dog has been vaccinated.

The backyard is fenced and is used for outdoor activities. Off limit areas are around the locked storage shed. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. There were no bodies of water observed. Director stated that facility does not have weapons on the premises.

LPA reviewed the facility's roster and obtained a copy. Fire and disaster drills were last conducted and recorded on 6/21/2022

Floors were clean. 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.

Children and Personnel Record /files was reviewed: Children records reviewed included: Identification and Emergency Information, Consent for Emergency Medical Treatment form, Notification of Parents Rights, Affidavit Regarding Liability Insurance and immunization.

Staff records reviewed include: Criminal Record and Child Abuse Index Background Check Clearance, Health Screening Report with TB Clearance, Immunization Record for Measles and Pertussis, Education Qualification, and required Training.

LPA reminded Director 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.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

LIC809 (FAS) - (06/04)

Page: 3 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: LARA-RAMIREZ, ROSIE	FACILITY NUMBER: 434413670
	VISIT DATE: 12/02/2022

NARRATIVE

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Safe Sleep
LPA discussed the safe sleep regulations with licensee Lara-Rmirez Rosie 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 [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

Notice of Site Visit
A notice of site visit was given and must remain posted for 30 days.
Posting Requirements
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Deficiencies were observed during this inspection and be review on attached D page.

Exit Interview
Exit interview conducted and report was reviewed with the licensee Lara-Ramirez, Rosie .

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

LIC809 (FAS) - (06/04)

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