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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400595
Report Date: 08/24/2022
Date Signed: 08/24/2022 08:35:13 PM

Document Has Been Signed on 08/24/2022 08:35 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:GARCIA, TISHFACILITY NUMBER:
434400595
ADMINISTRATOR:GARCIA, TISHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
4087293861
CITY:SAN JOSESTATE: CAZIP CODE:
95127
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
08/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Tish GariciaTIME COMPLETED:
05:15 PM
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Licensing Program Analyst (LPA) Stephanie Collins conducted an unannounced inspection of the family day care home. LPA met with Licensee Tish Garcia and explained the purpose of today's inspection.

There are (3) three adults residing in the home: Licensee and Licensee’s assistant (Daughter Katrina Najera) with husband (Matthew L. Martinez )and their (3) three children. Present during the inspection today was the licensee the licensee’s her daughter Karina Najera along with (10) ten preschool children.

Licensee's Pediatric CPR and First Aid expires on 2/11/23. Licensee's AB1207 Mandated Reporter Training Certificate expires on 10/23/2022.

LPA observed an updated roster of children in care. LPA reviewed the children's files. Records reviewed include Parents' Rights, immunization, Emergency Contact Information, and Consent for Emergency Medical Treatment form.

LPA inspected the indoor and outdoor areas of the home. Smoke and carbon monoxide detectors were tested and proved to be functioning. A fully charged fire extinguisher (3A40BC) was observed. The home was found to be kept clean and orderly with heating and ventilation for safety and comfort. The children have age appropriate toys and play equipment.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: GARCIA, TISH
FACILITY NUMBER: 434400595
VISIT DATE: 08/24/2022
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Disaster drills were last conducted and recorded on 7 /20 /2022. Licensee is aware fire/disaster drill are required to be preformed every 6 months . Off limit areas of home are All bedrooms. Outside backyard- off limit areas are sides of house. The backyard is fully fenced. No bodies of water observed.

Medication, cleaning products and similar items that can pose a danger to children if readily accessible are stored inaccessible to children. Licensee states that there are No weapons in the home. Licensee has two small sized pet dogs. Per Licensee the dogs are current with vaccinations.

Licensee stated she does not transport children. Licensee understands that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children in care shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system.

LPA reviewed with Licensee the maximum capacity for 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, including children under age 10 who reside at the licensee's home shall be either: (1) 12 children, no more than four of whom may be infants; or (2) 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.” LPA reminded Licensee that when Licensee does not have a Helper present, Licensee can only care for up to 8 children at any one time in the home and must follow the capacity requirement of a Small Family Child Care Home.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: GARCIA, TISH
FACILITY NUMBER: 434400595
VISIT DATE: 08/24/2022
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A review of Staff records indicates that all persons that require a caregiver background check have received criminal record and child abuse index clearances or exemptions. LPA informed Licensee of the applicable civil penalties for any adult who has not received fingerprint clearances, is not associated to the license and who comes in contact with or provides care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12- month period.

LPA discussed Senate Bill 792, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporting Training) which is required training that began on January 1, 2018 and requires renewal every two years, AB 633 was discussed with applicant Licensing forms, Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov. Mandated Reported Training can be accessed at www.mandatedreporterca.com.

LPA discussed the Individual Infant Sleeping Plan form 9227.

Website for resource information: http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates
LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list, childcareadvocatesprogram@dss.ca.gov

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list, childcareadvocatesprogram@dss.ca.gov.
The Mandated Reporter Training (AB1207) can be completed at the website listed. http://www.mandatedreporterca.com. LPA discussed and provided Lead Safety Information (AB2370) with the Licensee.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Tish Garcia




SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
LIC809 (FAS) - (06/04)
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