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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409589
Report Date: 10/11/2024
Date Signed: 10/14/2024 09:48:08 AM

Document Has Been Signed on 10/14/2024 09:48 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:MENDOZA, MICHELLE & STEVENFACILITY NUMBER:
434409589
ADMINISTRATOR/
DIRECTOR:		MENDOZA, M & SFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 274-6181
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
10/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:08 AM
MET WITH:Michelle and Steven MendozaTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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On 10/11/2024, at 9:08am, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced annual/random inspection. LPA was granted access to the home by Licensee, Michelle Mendoza and explained the nature of today’s inspection. Present in the home were licensee, co-licensee/spouse and 6 preschool age children. Children continued to arrive during the inspection. Licensees are operating within the ratio and capacity requirements of the license. Days and hours of operation are Monday to Friday, 7:00 am to 6:00 pm. LPA observed all required posted materials near the front entrance to the home. The entrance for the daycare is to the left of the main entrance which opens into the bonus room. There are four adults that reside in the home. Licensee has minor children residing in the home. Licensee submitted an updated Application for a Family Child Home License (LIC 279) and Current Children in the home (LIC 279B) during today's inspection.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensees have a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Children were observed to be engaged in tracing activities and playing with blocks. Furniture including diaper changing table and shelves, are in good condition. The home has central heating/cooling and ventilation for comfort of children. LPA observed a wall mounted air conditioner and fans in the bonus room. The home is single story. On limit areas inside the home: bonus room, one bathroom, dining area, living room and family room. LPA observed a barricaded fireplace in the living room.

Outdoor play area is fenced. Play structure was observed to be in good condition. LPA advised Licensees to follow manufacturer instructions for age of children permitted to use the play structure. LPA observed tan bark as resilient material under swings and high climbing structures. LPA observed a small lower part of the fence in the outdoor area is broken and the slats can be pushed easily in that section. LPA reminded Licensee that all areas on limit to children need to be safe and children need to be provided with safe, healthful, and comfortable accommodations, furnishings, and equipment while at the facility.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2024
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: MENDOZA, MICHELLE & STEVEN
FACILITY NUMBER: 434409589
VISIT DATE: 10/11/2024
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There are no bodies of water observed. LPA observed that the toilet and faucet in the bathroom are in operating condition.

LPA observed a fully charged fire extinguisher in the kitchen which was last serviced on 12/17/2023 and working smoke/carbon monoxide detectors. Licensee stated that she does not have any weapons or pets in the home. All cleaning compounds, medications and sharp objects were observed to be stored inaccessible to children. Licensees understand that smoking is prohibited in the home.

Drinking water is readily available for children in the home via water pitcher and individual water bottles and cups. Licensee states that they provide breakfast, lunch, dinner and snacks to the children in care. Licensees understand that any food brought from home shall be labeled with each child's name and properly stored or refrigerated. Licensee states that a child will be isolated in the family room if necessary due to illness or communicable disease.

LPA reviewed a current facility roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was last conducted on 07/15/2024. LPA obtained copy of children's roster.

Children file review was completed and found to be current and up to date. Seven (7) children’s files were reviewed during today's inspection. Licensees carry daycare insurance and LPA observed a current policy verifying valid coverage. LPA reviewed one infant's file and observed log of 15 minute nap check.

LPA discussed the safe sleep regulations with licensees, and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensees 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.

LPA reviewed Licensees files for the required forms. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MENDOZA, MICHELLE & STEVEN
FACILITY NUMBER: 434409589
VISIT DATE: 10/11/2024
NARRATIVE
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 Licensees have current CPR/First Aid Training which expires on 03/24/2026 and current Mandated Reporter Training's. 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 have the required immunization's in file for measles, pertussis and influenza.

Licensees were 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.

Supervision of children was discussed with Licensees, and they understand that they or a qualified adult must be present in the home during day care hours and ensure that the children are supervised at all times. LPA discussed the requirement for both licensees to be present at the facility 80 percent of the hours the facility is in operation and that temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. Licensees understands their capacity options and understand that they cannot have more than 14 children in the home at any time and a qualified assistant must be present. Licensees understands that in absence of a helper the license capacity is reduced to 8 and ratio (age of the children) must be observed.

Licensees are encouraged to frequently visit our website at www.ccld.ca.gov for licensing updates, provider information notices (PINs) and regulations.

This facility provides Incidental Medical Services – IMS. Licensee stated that child attends part time and parents bring the Epinephrine Auto injector every time the child is in attendance. For IMS information see PIN 22-02-CCP. LPA provided Licensee with a copy of PIN 22-02-CCP and Licensee will submit an Incidental Medical Plan to the Department by 10/25/2024.

The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: MENDOZA, MICHELLE & STEVEN
FACILITY NUMBER: 434409589
VISIT DATE: 10/11/2024
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Licensees stated that they transport children. LPA reminded Licensees that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system.

Licensees were 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, Licensees confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted and report was reviewed with the Licensee, Michelle Mendoza.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

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.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024
LIC809 (FAS) - (06/04)
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