434416384-7-6-2023-07-CC-ALOZ-CTGPGC-20230706111806

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416384
Report Date: 07/06/2023
Date Signed: 07/06/2023 11:18:11 AM

Document Has Been Signed on 07/06/2023 11:18 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:	CAIMOL, ANISIA		FACILITY NUMBER:	434416384
ADMINISTRATOR:	CAIMOL, ANISIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 788-6723
CITY:	CAMPBELL	STATE: CA	ZIP CODE:	95008
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 6	DATE:	07/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Anisia Caimol		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 met with Licensee, Anisia Caimol for an unannounced Required – 1-year annual inspection. LPA was granted access to the home by the Licensee. LPA also observed 6 preschool children and 1 adult assistant in the home during today's inspection. Licensee was operating within her capacity and ratio requirements. LPA observed the required postings, including the facility license, near the front entrance to the home. Days and hours of operation are Monday - Friday from 8:30am - 6:00pm. The adults residing in the home are: Licensee and spouse. LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on 5/5/23. Licensee states that she currently does not have liability insurance for the day care. Licensee and assistant have current CPR and First Aid certifications (licensee exp: 5/2025 & assistant exp:11/2023). Licensee is current with the required vaccines (MMR, Tdap, & Flu). Licensee is current with her Mandated Reporter Training for General Training, but will complete the Mandated Reporter training for Child Care Providers and submit it to licensing. The assistant is also current with her required vaccines (MMR, Tdap, & Flu) and is up to date with her Mandated Reporter Training for Child Care Workers (exp: 11/2023). LPA reviewed 5 children's files and the files were complete with the required forms. LPA reviewed the licensee and assistant's file and they were complete with the required forms. LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (925)788-6723. 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. LPA did not observe any stairs or wall heaters inside the home. Licensee states children bring their lunches from home, she does provide AM and PM snacks for the children. Off limit areas inside the home are all 4 bedrooms, the hall bathroom, the kitchen, and the garage. Off limit area outside the home is the locked storage shed in the backyard. ------------------------------continued on page 2-----------------------------------------------

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023

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: CAIMOL, ANISIA	FACILITY NUMBER: 434416384
	VISIT DATE: 07/06/2023

NARRATIVE

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LPA observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. The Licensee states that there are no weapons in the home. All detergents, cleaning compounds, medications, and other similar items are kept locked in the kitchen and inaccessible to children. Licensee states that she does administer some medications (tylenol or allergy) to the day care children. Licensee has a first aid kit in the home and touch less 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: https://www.ada.gov/resources/child-care-centers/.

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 or outside if necessary due to illness or communicable disease. Licensee states that they do not transport 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 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
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SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023

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: CAIMOL, ANISIA	FACILITY NUMBER: 434416384
	VISIT DATE: 07/06/2023

NARRATIVE

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Licensee stated she does not have any infants enrolled in the day care. LPA briefly discussed the safe sleep regulations with 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 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 may 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 CARE tools, please send email inquiries 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/inspection-process.

Exit interview conducted and report was reviewed with the Licensee, Anisia Caimol.

No deficiencies were issued during today's inspection.
A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023

LIC809 (FAS) - (06/04)

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