274450180-12-20-2023-07-CC-FCJO-CYPUXD-20231220145811

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274450180
Report Date: 12/20/2023
Date Signed: 12/20/2023 02:58:17 PM

Document Has Been Signed on 12/20/2023 02:58 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:	VARGAS, CINTYA		FACILITY NUMBER:	274450180
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 4	DATE:	12/20/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Cintya Vargas		TIME COMPLETED:	03:10 PM

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) Fermin Campos-Jaramillo conducted an unannounced inspection to the home today. LPA met with Cintya Vargas, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Saturday from 7:00 AM to 5:00 PM. The adults that reside in the home are the Licensee, her spouse Daniel, her adult children Daniel and Maritssa, her sister Mary, and her mother Margarita. LPA observed two preschool children, one school age, and one infant were in care during the inspection. Certification for CPR and First Aid Card for Licensee is current and will expire on 7/02/24. LPA toured the indoor areas of the home during today's inspection. LPA obtained a copy of the children's roster today. LPA observed that Licensee has conducted a fire drill during the last six months. Last fire drill was documented on 10/06/23. LPA reviewed five children files and are complete including the parent's rights form and the immunization records form. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas inside are: Three bedrooms and two bathrooms, and the attached garage. Off limits areas outside: All the right side yard and the back yard. LPA observed the left side yard is used as playground for children and it is fenced. LPA observed a fully charged 2A10BC fire extinguisher last time services on 10/14/22. LPA observed the home has at least one smoke/carbon monoxide detector. LPA observed there are not stairs in the home. Licensee keeps two dogs in the back yard and they are vaccinated. Licensee states that there are not weapons in the home. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. According with the SB792, Licensee has presented proof that she has immunization for herself for measles, pertussis and influenza. Report dated 12/20/23 continues in page 2.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: VARGAS, CINTYA	FACILITY NUMBER: 274450180
	VISIT DATE: 12/20/2023

NARRATIVE

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Report dated 12/20/23 continues from page 1.

Supervision of children was discussed with Licensee and she understands that she or qualified helpers must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands the capacity options and she understands that she cannot have more than 8 children in care in the home at any time. Licensee states that she does not transport children via vehicle and that she understands that children cannot be left in parked vehicles unattended at any time.

Department website: www.ccld.ca.gov provided to Licensee.

LPA observed that licensee has renewed the Mandated Reporter training on 5/26/23 Licensee understands the training shall be renewed every two years. Training website: www.mandatedreporterca.com

A review of staff records on 12/13/23 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Licensee was reminded that all the 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.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

*****************************Report dated 12/20/23 continues in page 3

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: VARGAS, CINTYA	FACILITY NUMBER: 274450180
	VISIT DATE: 12/20/2023

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********Report dated 12/20/23 continues from page 2.

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/.

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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Cintya Vargas confirmed that there are no Registered Sex Offenders living in the facility.

Exit interview conducted and report was reviewed with the licensee Cintya Vargas.

No deficiencies were cited today.

A notice of site visit was handed to licensee and must remain posted for 30 days.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

LIC809 (FAS) - (06/04)

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