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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434407129
Report Date: 03/26/2024
Date Signed: 03/26/2024 03:17:52 PM

Document Has Been Signed on 03/26/2024 03:17 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:TASHIRO, NARUMIFACILITY NUMBER:
434407129
ADMINISTRATOR:TASHIRO, NARUMIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 586-8711
CITY:SAN JOSESTATE: CAZIP CODE:
95132
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/26/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Narumi TashiroTIME COMPLETED:
03:00 PM
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On 03/26/2024 at 2:00pm Licensing Program Analyst (LPA) Farida Raja and Licensing Program Manager (LPM) Gladys Kuizon met with Licensee, Narumi Tashiro for an Informal Meeting. The pre-scheduled meeting took place at the San Jose Regional Licensing Office.

On 08/11/2023 at 8:50 am, LPA conducted an unannounced facility visit and observed one infant being swaddled for nap. Licensee did not have current CPR/ First Aid and Mandated Reporter trainings and had not conducted and logged a fire drill in the last 6 months. LPA observed two baby bouncers in the on-limit family room. During children’s file review, LPA did not observe an Individual Infant Sleep Plan (LIC 9227) or log of 15-minute nap checks for one infant in care. During facility walk through, LPA observed items which could pose a danger to children stored within reach of children under the bathroom sink and in the backyard of the home. The facility was cited 2 Type A and 7 Type B deficiencies during the visit.

LPA conducted a case management inspection on 02/01/2024 at 12:40pm. LPA arrived when children were napping and LPA observed three children asleep in cribs in the off-limits master bedroom with the door closed. During children’s file review LPA observed that five out of seven children did not have the signed Acknowledgement of Receipt of Licensing Reports form (LIC 9224) for the Type A deficiencies cited on 08/11/2023. LPA observed that one infant did not have the Individual Infant Sleep Plan (LIC 9227) which is a repeat violation within a 12 month period. Facility was cited 4 Type B deficiencies during the case management visit. Civil penalties in the amount of $250 are being issued during today’s office visit. LPA obtained Licensee’s signature on the amended report. The facility also has a history of 13 Type A and15 Type B citations.

The purpose of the informal meeting is to review the deficiencies with the Licensees and discuss the plan of corrections submitted by the licensee to ensure licensee’s understanding of Title 22 violations that led to the deficiencies.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/26/2024
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: TASHIRO, NARUMI
FACILITY NUMBER: 434407129
VISIT DATE: 03/26/2024
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LPM Gladys Kuizon explained the informal meeting and the administrative process. Licensee was advised that continued non-compliance with Title 22 Regulations could result in their license being referred to Community Care Licensing's legal department for review and possible action against the license.

During the meeting, Licensee was reminded that whenever there is an issuance of Type A citations, a copy of the Facility Evaluation Report LIC809 has to be posted in the facility and a copy must be given to all parents of current and newly enrolled children for next 12 months. In addition, a copy of LIC9224 Acknowledgement of Receipt of Licensing Reports needs to be signed and kept in children’s files. LPM reviewed Safe Sleep Regulations with Licensee.

Licensees understands that the facility will be placed under increased monitoring to ensure compliance with Title 22 regulations. LPM discussed with licensee plans to bring facility into compliance. LPM and LPA provided staffing and capacity ratio visual chart to the Licensee during today's visit.



LPM informed licensee to review Child Care Licensing website for important updates to regulations and webinars offered. Licensee stated that they understand and will visit childcare licensing website and review updates. Licensee stated that they have already signed up to receive updates.

This report was discussed with and a copy provided to Licensee, Narumi Tashiro.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2024
LIC809 (FAS) - (06/04)
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