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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415777
Report Date: 10/13/2020
Date Signed: 10/14/2020 09:20:50 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:WALKER, ELAINEFACILITY NUMBER:
434415777
ADMINISTRATOR:WALKER, ELAINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 836-4293
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY:14CENSUS: 3DATE:
10/13/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Elaine WalkerTIME COMPLETED:
10:35 AM
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Licensing Program Analyst (LPA) Dung Mac conducted an announced case-management tele-inspection via video conference call (FaceTime) with Elaine Walker, Licensee, in response to Licensee’s request to use the Living Room for daycare. A fire clearance was granted by the San Jose Fire Department on September 22, 2020 for day care use of the Living Room, Dining room, Dining area, Bathroom, and Classroom (converted garage). Days and hours of operation are Monday to Friday from 7:00AM to 6:00PM.

LPA inspected the day care via FaceTime during today's tele-inspection. LPA observed Licensee's adult daughter (Leah Walker), Assistant (Patrice Duncan), and three daycare children (one infant and 2 preschoolers) in the home during today's tele-inspection. Areas that will be used for day care are Living room, Dining room, Dining area, Bathroom, and converted garage. Children will enter the day care through a side gate next to the main activity room. Licensee has a designated area in the home where a child(ren) can be isolated if exhibiting signs of illness. LPA observed a barricaded fireplace in the living room. Licensee stated that there are no wall heaters in the home.

Licensee stated that cleaning products, medications, hazardous, sharp objects, and similar items that are dangerous to children in care were stored inaccessible, out of reach of children. Licensee stated that there are no poisons inside the home.

Licensee stated that she does not have any baby walkers/inclined sleepers in the home and understands that baby walkers/inclined sleepers are not allowed in the home. Licensee stated that she does not have any baby bouncers, jumpers, saucer chairs in the home. LPA observed toilet and faucet are clean. No medication, mouthwash, perfumes, razors, cleaning products, air fresheners, and nail polish/remover were observed.

Licensee was informed that due to the current Covid-19 pandemic and "Shelter In Place" Order, the Facility Evaluation Report will be emailed to Licensees (email: mselainepreschool@gmail.com) with "Read Receipt" notification. Licensee understands that her reply to the email will serve as acknowledgement that the report was received.

LPA conducted an exit interview and advised Licensee that the Living Room will be approved for day care use upon receiving of acknowledgement of "receipt" of today's report.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung MacTELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2020
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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