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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416286
Report Date: 02/10/2022
Date Signed: 02/10/2022 04:44:26 PM

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:NOVOA DUQUE, JOSUEFACILITY NUMBER:
434416286
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
02/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Josue NovoaTIME COMPLETED:
05:00 PM
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Licensing Program Analysts (LPAs) Aman Sharma and Mel Matos met with Josue Novoa Duque, Licensee, for an unannounced Required – 1 year annual inspection.
LPAs were granted access to the home by the Licensee. LPAs also observed 5 children napping and one child being held by a staff. Two staff were also present during todays inspection. Licensee was operating within his capacity and ratio requirements. LPAs observed the required postings, including the facility license, near the front entrance of the home. Days and hours of operation are Monday - Friday from 8:00 AM to 5:30 PM. Licensee and two children are the individuals residing in the home.

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 October 20, 2021. Licensee has current CPR and First Aid certifications (expiration:11/5/2022). Licensee has the required vaccines and is current with his Mandated Reporter Training for Child Care Workers (expiration: 11/13/2022). LPAs reviewed child's file and the file was complete with the required forms. LPAs reviewed one staff file and the file was complete with the required forms. Licensee states that a child will be isolated in the dining room if necessary, due to illness or any COVID19 symptoms.

LPAs discussed the safe sleep regulations with the Licensee 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. 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.

LPAs toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home. The home is clean, orderly, and safe for the day care children.

SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: NOVOA DUQUE, JOSUE
FACILITY NUMBER: 434416286
VISIT DATE: 02/10/2022
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There is a fireplace in the family room day care which is covered. The off limit areas inside the home are: three bedrooms, one bathroom, one closet and garage. There are safe and age appropriate toys, play equipment, and materials for the children in the home.

LPAs observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors. The Licensee states that he does not have any weapons in the home. In the on-limit areas, there were chemicals found in the bathtub as well as under the sink which the licensee removed while LPAs were present. Licensee states that there are no poisons in the home. Licensee states that he does not administer any medication to the day care children at this time. Licensee has a first aid kit in the home.

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.

Supervision of children was discussed with the Licensee and he understands that he must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands his capacity options and he understands that he cannot have more than 8 children in the home at any time. Licensee states that he does 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.


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, Josue Novoa Duque. No deficiencies issued during today's inspection. LPAs advised licensee that a large family day care home will be reviewed and approved by management.

A Notice of Site Visit was given and must remain posted for 30 days

SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
LIC809 (FAS) - (06/04)
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