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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274407065
Report Date: 06/19/2024
Date Signed: 06/19/2024 01:40:20 PM

Document Has Been Signed on 06/19/2024 01:40 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SANTILLAN, JUANAFACILITY NUMBER:
274407065
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
06/19/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:44 AM
MET WITH:Juana SantillanTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 06/19/24 at 09:30 AM., Licensing Program Analyst (LPA) Teodoro Trujillo conducted an unannounced Case Management- Licensee Initiated inspection. LPA met with licensee Juana Santillan, and explained the reason for the inspection. The purpose of this inspection is Licensee is requesting a change of capacity to a large family child care. A fire clearance for 14 children was granted on 06/17/2024. Present during today's inspection were licensee, spouse Manuel, adult son Gabriel and nephew Manuel with six preschool children. Licensee, spouse Manuel, Son Gabriel, and nephew Manuel are the adults residing in the home, there are no minor children.

LPA toured the inside and outside of the home. LPA observe the off limit garage door propped open, two off limit bedroom doors open, and hallway baby gate open leading to the off limit bedrooms. The off-limit areas of the home are master bedroom with master bathroom, bedroom two, three and four, attached garage, and bathroom two. LPA observed no stairs during today's visit. On limit areas include the living room, dinning room, bathroom three next to bedroom 4 and kitchen. Licensee stated that children will only use the dining room and living room, and sick children will be isolated in the living room if necessary due to illness or communicable disease. There are sufficient toys for the children in care. LPA observed that disinfectant, cleaning supplies, and other items that are dangerous to children were accessible to children, door to the off limit garage was open with cleaning supplies and detergent on the garage floor. On limit bathroom had multiple tubes of Desitin, Butt Paste, Barrier and Gelmicin within reach of children. Napping mats are appropriate, infant crib and playpen need fitted sheets. There is a fully charged fire extinguisher, smoke detector, and carbon monoxide detector and fire pull station. Licensee stated that there is one cat in the home, and no weapons including firearms in the home.

Backyard was observed to be fenced. The entrance to the daycare is through the front door. The outside play area is located in front of the front yard, gate leads to the front of the garage. The off-limit areas outside include the barricaded right side yard, rear and left side yard area. LPA did not observe bodies of water.

All adults have cleared criminal record, child abuse, and Tuberculosis test. Licensees Juana Santillan has completed Family Child Care Home Orientation, Preventive Health, Safety, Nutrition and Lead Poisoning training, current Pediatric CPR and First Aid certification and obtained immunization's for measles, pertussis and influenza.



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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2024
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SANTILLAN, JUANA
FACILITY NUMBER: 274407065
VISIT DATE: 06/19/2024
NARRATIVE
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Licensee owns the home, proof of control of property is on file, licensee has current child care insurance with Markel Insurance Company.

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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA reminded licensee to obtain a copy of an Individual Infant Sleeping Plan (LIC 9227) for infants 12 months and under and conduct and log 15- minute sleeping infant check for children under 2 years of age.

Supervision of children was discussed with licensee, and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity options and she understand that she cannot have more than 14 children in the home at any time. Licensee understands if she transports children via vehicle, children cannot be left in parked vehicles unattended at any time.
LPA discussed with Licensee about the maximum capacity requirement of a Large Family Child Care Home License. The maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home shall be either 12 children, no more than four of whom may be infants; or more than 12 and up to 14 children if at least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age and there are no more than three infants being cared for during any time when more than 12 children are being cared for. When Licensee have more than 12 and up to 14 children in the home, Licensee must notify the parent using the form LIC 9150 (Parent Notification Additional Children in Care).

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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SANTILLAN, JUANA
FACILITY NUMBER: 274407065
VISIT DATE: 06/19/2024
NARRATIVE
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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/.

Type A deficiencies were cited during today's visit. LPA Teodoro Trujillo informed licensee Juana Santillan that this report dated 06/19/24 document(s) 1 (one) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Teodoro Trujillo informed the licensee Juana Santillan to provide a copy of this licensing report dated 06/19/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the licensee Juana Santillan.



A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

As a result of today's inspection, there were deficiencies cited. Licensee was informed that a Large Family Child Care Home License will be pending licensing program manager(LPM) approval.
1. written statement of preventive measures to maintain off limit area’s closed.
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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/19/2024 01:40 PM - It Cannot Be Edited


Created By: Teodoro Trujillo On 06/19/2024 at 12:46 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SANTILLAN, JUANA
FACILITY NUMBER: 274407065

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/20/2024
Section Cited
CCR
102417(g)(4)(A)

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Operation of A Family Child Care Home
The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. (A) Storage areas for poisons, firearms and other dangerous weapons shall be locked.

This requirement is not met as evidenced by:
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Licensee to submit a written plan of correction explaining how she will maintain her home free of unsafe items and make them inaccessible to children at all times to LPA by plan of correction date of 06/19/2024.
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Based on observation and interview, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. LPA observed cleaning products and detergents in the open off limit garage, tubes various diaper rash products and two pairs of scissors in the bathroom area within reach of children.
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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:Susy Cervantes
LICENSING EVALUATOR NAME:Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:
DATE: 06/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/19/2024


LIC809 (FAS) - (06/04)
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