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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274417325
Report Date: 03/21/2023
Date Signed: 03/21/2023 11:06:23 AM

Document Has Been Signed on 03/21/2023 11:06 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:BEBAWI, EVALENFACILITY NUMBER:
274417325
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/21/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Evalen BebawiTIME COMPLETED:
11:25 AM
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Licensing Program Analyst (LPA) Joe Macias conducted an announced Prelicensing Inspection. The LPA met with the Applicant Evalen Bebawi and disused the nature of today's inspection. The purpose of today’s inspection is to ensure the home is in compliance with Title 22 California Code of Regulations. The Applicant her adult daughter Karoleen Bebawi, and adult son's Mina Bebawi, Beshoy Bebawi are the only adult who reside in the home. The hours of operation are Monday - Friday, 6am - 6pm. The Applicant's CPR and First Aid are current, and expire March 2025. The Applicant has completed the Lead Poisoning Prevention Training. Applicant may obtain liability insurance upon receiving her license.

LPA toured the indoor and outdoor areas of the home during today's inspection. The Applicant has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the children in care. The home is orderly, and safe for the day care children. LPA did not observe a wall heater in the home (central heat). LPA observed a securely barricaded/ gated stair case in the home. The off limit areas inside the home are: entire second floor, side yard, and garage.

LPA observed a fully charged 2A10BC fire extinguisher, working smoke, and carbon monoxide detectors. LPA did not observe a body of water. The Applicant states that she does not have weapons in the home. All detergents, cleaning compounds, poisons, medications, and other similar items are out of reach and inaccessible to children. Applicant states that she does not plan on administering medications.

Applicant will be using communication, positive reinforcement, and good modeling of behaviors as forms of discipline. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Discussed isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute. LPA informed applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Joseph Macias
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2023
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: BEBAWI, EVALEN
FACILITY NUMBER: 274417325
VISIT DATE: 03/21/2023
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LPA discussed the safe sleep regulations with the Applicant 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.

A review of staff records on March 21, 2023 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The Applicant Evalen Bebawi 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

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm



The Applicant has completed the Mandated Reporter Training.

Exit interview conducted and report was reviewed with the Applicant Evalen Bebawi. The Applicant was advised that a small family child care license will be issued pending management approval.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Joseph Macias
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023
LIC809 (FAS) - (06/04)
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