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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400595
Report Date: 02/28/2024
Date Signed: 02/28/2024 04:53:35 PM

Document Has Been Signed on 02/28/2024 04:53 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:GARCIA, TISHFACILITY NUMBER:
434400595
ADMINISTRATOR:GARCIA, TISHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 729-3861
CITY:SAN JOSESTATE: CAZIP CODE:
95127
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
02/28/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Tish GarciaTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Sheena Chin met with Licensee, Tish Garcia, for an unannounced annual inspection. LPA explained the nature of today’s inspection to Licensee. Present during today’s inspection were 6 children, the licensee, and her helper (daughter) in the facility. Days and hours of operation are Monday to Friday, 8am to 5pm. The adults that reside in the home are licensee, her 2 daughters and a son-in-law. The licensee stated the ownership of the home and that the facility only accepted preschoolers without diapers. The patio cover construction was going on in the backyard during the inspection. LPA advised the licensee to notify the licensing department if deciding to have any renovation or construction.

Observation
LPA observed that required postings were posted. LPA, along with the licensee toured the inside and outside of the home. The facility has a full charged fire extinguisher, 3A40BC. A smoke detector was working properly. The facility sketch that the licensee submitted to the licensing department did not cover the entire property. The licensee stated that she would redraw the facility sketch and send it to LPA. The licensee stated that the off-limit areas inside in the home were all bedrooms and the office. All disinfectant, cleaning supplies, and other items that could pose a risk to children were observed to be inaccessible. LPA observed that there are toys for children.

LPA observed that the licensee stored the outdoor furniture in the living area, where children were having activities. The licensee stated that the facility had a grant to purchase the outdoor furniture for outdoor activities after the completion of the patio cover construction. The licensee stated that the products were stored outside but brought inside due to the rains. LPA advised the licensee to put the products in order and ensure children will not get hurt if anything fell from the storage. Three dogs were observed in the facility. The licensee stated that the dogs’ vaccines were current and presented the vaccination cards for dogs.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2024
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: GARCIA, TISH
FACILITY NUMBER: 434400595
VISIT DATE: 02/28/2024
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Observation
A patio cover construction was observed in the back yard. The licensee used fence to block the entrance to the construction site. The outdoor play area was surrounded by appropriate fencing and had canopies for shades. The outdoor equipment was age-appropriate and in good condition. There was a climbing structure in the playground that was age appropriate and had rubber tiles underneath to absorb falls.

LPA conducted CARE Tools for this annual inspection, which include Physical Plant, Care and Supervision, Facility Administration, Records, Staffing Ratio and Capacity, Personnel Rights for compliance with all licensing statutes, regulations, and interim licensing Standards, and results were documented on the tool.

Records review
The Licensee has current CPR and First Aid certifications expiring 2/9/25 . The Licensee has the child abuse training certificate, expiring 1/15/2025. LPA reviewed the fire and disaster drills log which is to be done at least once every six months. The last drills were conducted on 10 / 4 / 23 .

LPA reviewed 7 children files. Immunization records are maintained and updated in form PM 286. LPA observed Notification of Parents’ Rights is in each child’s file, and 15 min. sleeping check logs for infants under 2 years old.
During today’s inspection, all adults present or residing in the home have criminal record clearances required by the Department. 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: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024
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: GARCIA, TISH
FACILITY NUMBER: 434400595
VISIT DATE: 02/28/2024
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Discussion
Supervision of children was discussed with Licensee, who 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. Licensee states that she does not transport children via vehicle but she understands that children cannot be left in parked vehicles unattended at any time.

Deficiency
There were no deficiencies cited at this time.

Further questions
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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
During the exit interview, the Licensee, Tish Garcia, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
Notice of site visit was given and must remain posted for 30 days.
Exit interview was conducted and report was reviewed with the Licensee, Tish Garcia.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024
LIC809 (FAS) - (06/04)
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