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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409794
Report Date: 07/29/2024
Date Signed: 07/29/2024 05:10:07 PM

Document Has Been Signed on 07/29/2024 05:10 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:TA, VINH & CONG HUYEN, TUYET MAIFACILITY NUMBER:
434409794
ADMINISTRATOR/
DIRECTOR:		TA, VINH & CONG HUYEN, TUYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 281-4659
CITY:SAN JOSESTATE: CAZIP CODE:
95121
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
07/29/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:23 AM
MET WITH:Vinh TaTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 07/29/2024 at 10:23am, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced annual/random inspection. LPA was granted access to the home by Licensee, Vinh Ta, and explained the nature of today’s inspection. Co-licensee/spouse, Tuyet Mai was not present during today's inspection. Present during the inspection were Licensee and 6 school age children. Days and hours of operation are Monday to Friday, 8:00 am to 8:00 pm. LPA observed all required posted materials near the front entrance to the home. There are three adults residing in the home: Licensee, spouse and one son. Licensee stated that no minor children reside in the home. Licensee submitted an updated Application for a Family Child Care Home License (LIC 279) during today's inspection.

LPA toured the indoor and outdoor areas of the home during today's inspection. The home is single story with 3 bedrooms and 2 bathrooms. Licensee has a working telephone in the home (408-281-4659). LPA observed children playing in the family room during today's inspection. The floors were free of tripping hazards. The home has central heating/cooling and ventilation for comfort of children. Off limit areas inside the home: master bedroom, master bathroom, two bedrooms, laundry room, attached garage and barricaded fireplace in the family room. Off limit areas outside the home: left side section & back sections of the backyard and two storage sheds. Backyard is fenced and both sides of the home are gated. In the outdoor area next to the deck LPA observed one can of insect killer and garden tools in the on limit area accessible to children in care. LPA observed a two empty water tables in the backyard and reminded Licensee about the Department's zero tolerance regulations regarding water bodies. LPA reminded licensee to empty water tables after each use. No bodies of water were observed. LPA observed the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. LPA observed several cleaning products under the bathroom sink that have not been made inaccessible to children. Licensee placed can of insect killer and removed the cleaning products under the bathroom sink and placed it in an off limit area during today's inspection.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: TA, VINH & CONG HUYEN, TUYET MAI
FACILITY NUMBER: 434409794
VISIT DATE: 07/29/2024
NARRATIVE
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LPA observed a 3A40BC fire extinguisher in the laundry area and working smoke/carbon monoxide detectors. LPA reminded licensee that the fire extinguisher needs to be serviced once every 12 months. Licensee states that he does not have any weapons in the home. Licensee has one pet cat. Licensee understands that smoking is prohibited in the home.

Drinking water is available for children in the home. Licensee states that children bring their lunches and they provide 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. Licensee states that a child will be isolated in the living room if necessary due to illness or communicable disease.



LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was last conducted on 06/02/204. LPA obtained copy of children's roster.

Children file review was completed. Six (6) children’s files were reviewed during today's inspection. LPA observed that child (C6) does not have the required forms in file. Licensee does not have liability insurance for the day care and issues the Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282). Licensee is not caring for any infants or preschoolers and stated that they do not plan to care for infants or preschoolers and will only provide care to school age children.

LPA reviewed Licensee's file. 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. Licensee, Vinh Ta, has current Pediatric CPR/First Aid certification with an expiration date of 10/03/2024 and Mandated Reporter Training with an expiration date of 07/05/2025. Licensees have proof of immunization for measles and pertussis. LPA reminded licensee that the pediatric CPR and First Aid and Mandated Reporter Training need to be renewed every two years. LPA provided licensee with a copy of Entrance Checklist for Family Child Care Homes (LIC 126) during today's inspection.

Licensee, Vinh Ta 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: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
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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: TA, VINH & CONG HUYEN, TUYET MAI
FACILITY NUMBER: 434409794
VISIT DATE: 07/29/2024
NARRATIVE
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Supervision of children was discussed with Licensee, and he understands that he 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 Licensee and co-licensee 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. Licensee understands their capacity options and understands that he 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 his license capacity is reduced to 8 and ratio (age of the children) must be observed.

LPA discussed "zero tolerance" related regulations which includes the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. A $500 immediate civil penalty 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. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

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. The Department will communicate all new information to providers through Provider Information Notices (PINs). Please sign up to be notified for new PINs at www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and visit the Department’s website for the latest PINs.

Incidental Medical Services (IMS) policy was discussed. Licensee stated that he is not administering any medications or IMS to children at this time. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding 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: https://www.ada.gov/resources/child-care-centers/.

Licensee states that they do not transport any day care children. LPA reminded Licensee that if he decides to transport children, children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

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

DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
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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: TA, VINH & CONG HUYEN, TUYET MAI
FACILITY NUMBER: 434409794
VISIT DATE: 07/29/2024
NARRATIVE
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Licensee was 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, the licensee confirmed that there are no Registered Sex Offenders living in the facility. One Type A and one Type B deficiency was cited as a result of today's inspection. Due to the issuance of a Type A Citation during today's inspection, a copy of this Licensing Report must be given to each existing parent by the end of today or next day child is in care, and to any newly enrolled parents/guardians enrolled over the next 12 months from the date of this report. In addition, a copy of the LIC 9224 Acknowledgement of Receipt of Licensing Reports must be signed by each parent and kept in each child's file.

Exit Interview was conducted, where this report, the citations, plan of correction and appeal rights were reviewed and discussed with Licensee, Vinh Ta. Citations are issued on 809-D pages of this report. Licensee signed the report acknowledging receipt of documents. LPA reminded Licensee that failure to correct deficiencies by Plan of Correction Due Date may result in penalties.


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: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/29/2024 05:10 PM - It Cannot Be Edited


Created By: Farida Raja On 07/29/2024 at 12:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: TA, VINH & CONG HUYEN, TUYET MAI
FACILITY NUMBER: 434409794

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. During the facility walkthrough, LPA observed a can of insect killer and gardening tools near the outside deck accessible to children and several bottles of cleaning products in the on limit bathroom that are not made inaccessible to children.
POC Due Date: 07/30/2024
Plan of Correction
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Licensee placed insect killer and cleaning products inaccessible during today's inspection. Licensee to submit a written plan stating understanding of regulations to LPA by POC date of 07/30/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/29/2024 05:10 PM - It Cannot Be Edited


Created By: Farida Raja On 07/29/2024 at 12:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: TA, VINH & CONG HUYEN, TUYET MAI
FACILITY NUMBER: 434409794

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(7)
Operation of A Family Child Care Home
(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above for one child (C6) which poses a potential health, safety or personal rights risk to persons in care. Licensee did not maintain the required forms for Child, C6.
POC Due Date: 08/12/2024
Plan of Correction
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Licensee will have parents or authorized representatives complete the required forms and submit proof to LPA by POC date of 08/12/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2024


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