434402447-5-30-2023-07-CC-FRAA-CSBLSS-20230530090109

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434402447
Report Date: 05/26/2023
Date Signed: 05/30/2023 09:01:22 AM

Document Has Been Signed on 05/30/2023 09:01 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:	LAM, REBECCA		FACILITY NUMBER:	434402447
ADMINISTRATOR:	LAM, REBECCA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 238-1230
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95121
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 9	DATE:	05/26/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Rebecca Lam		TIME COMPLETED:	11:50 AM

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	On May 26, 2023 at 8:45am, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced 1- year annual inspection. LPA was granted access to the home by Licensee, Rebecca Lam, and explained the nature of today’s inspection. Present during the inspection were licensee, licensee's spouse (Yeung Lam), and 9 children including one infant and 8 preschool children. Licensee was operating within the ratio and capacity requirements of her license. Days and hours of operation are Monday to Friday, 8 am to 5:30 pm. LPA observed all required posted materials in the play area of the home. The adults that reside in the home are Licensee, Spouse and one adult son. All individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (408-238-1230). LPA observed sufficient materials, toys, and play equipment for the day care children. Furniture, such as tables, chairs, cribs, feeding chairs and shelves, are in good condition. The floors were free of tripping hazards with toys put away in shelves. The home has central heating/cooling and ventilation for comfort of children. The home is single story. Off limit areas inside the home: living room, two bedrooms, office, attached garage and barricaded fireplace in the family room. Off limit areas outside the home: left and right side section and are barricaded with a chain link fence. Backyard is fenced and both sides of the home are gated. There are no bodies of water observed. LPA observed that the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. The shower area is free of any hazards. All detergents, cleaning compounds, medications, sharp objects and other similar items are stored inaccessible to children. LPA observed a fully charged 3A40BC fire extinguisher in the play area. Carbon monoxide and smoke detectors in the family room were tested and proved to be functioning. The Licensee states that there are no weapons or pets in the home. LPA observed a first aid kit on a high shelf in the family room. Continued on page 2

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023

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: LAM, REBECCA	FACILITY NUMBER: 434402447
	VISIT DATE: 05/26/2023

NARRATIVE

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Drinking water is readily available for children in the home via individual water bottles. Licensee states that she provides breakfast, lunch and snacks to the children in care. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored or refrigerated.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was last conducted on 04/05/2023. LPA obtained copy of children's roster. Children file review was completed and found to be current and up to date. Nine (9) children’s files were reviewed during today's inspection. Licensee carries daycare insurance. Licensee has liability insurance through Markel Insurance and LPA observed a current policy verifying valid coverage. LPA discussed the safe sleep regulations with Licensee, including conducting 15-minute checks on all sleeping infants. LPA discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA provided licensee with a copy of an Individual Infant Sleeping Plan (LIC 9227) and a sample 15-minute sleeping infant check form.

Staff file review was completed and found to be current and up to date. LPA reviewed two staff files (Licensee and Spouse) and the files were complete with the required forms. Licensee or spouse did not have current CPR/First Aid Training. Licensee stated that they did not complete the training due to COVID concerns and made an appointment for 05/28/2023 while LPA was present. Licensee has proof of immunization in file for measles and pertussis. Licensee's Mandated Reporter Training expires on 02/17/2025. Licensee understands the training is mandatory to all licensees and adults in the home in contact will children and requires renewal every two years.

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. 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.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023

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: LAM, REBECCA	FACILITY NUMBER: 434402447
	VISIT DATE: 05/26/2023

NARRATIVE

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Supervision of children was discussed with Licensee, and she understands that she or a qualified adult must be present in the home during day care hours and ensure that the children are supervised at all times. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time and a qualified assistant must be present. Licensee understands in absence of a helper her license capacity is reduced to 8 and ratio (age of the children) must be observed. Licensee stated that she does not transport any day care children.

LPA discussed "zero tolerance" related regulations and advised that the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. A $500 immediate civil penalty and $100 per day violation until corrected is assessed for serious violations such as absence of supervision, accessible bodies of water, accessible firearms, refused entry of licensing staff, presence of an excluded person, and violations that result in illness or injury. Licensee is encouraged to visit the Department’s website at https://cdss.ca.gov/inforesources/child-care-licensing to access general updates, resources for providers, regulations, adoptions of new laws, pay annual fees etc.

Licensee states that a child will be isolated away from the other children if necessary due to illness or communicable disease until parent pick-up. Licensee states that she does not administer any medications to the day care children at this time. Incidental Medical Services (IMS) policy was discussed. LPA provided Licensee with a copy of PIN 22-02. 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 Americans with Disabilities Act (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.

As a result of today's inspection, there were no deficiencies cited.

Exit interview conducted and report was reviewed with the Licensee, Rebecca Lam .

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS

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@dess.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/process.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023

LIC809 (FAS) - (06/04)

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