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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434411028
Report Date: 01/31/2025
Date Signed: 02/03/2025 08:30:13 AM

Document Has Been Signed on 02/03/2025 08:30 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:NGUYEN, TRINHFACILITY NUMBER:
434411028
ADMINISTRATOR/
DIRECTOR:		NGUYEN, TRINHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 677-4308
CITY:SAN JOSESTATE: CAZIP CODE:
95121
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
01/31/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Trinh NguyenTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On 01/31/2025 at 12:20pm, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced annual inspection. LPA was granted access to the home by Assistant, Mackenzie Moek and explained the nature of today’s inspection. Upon arrival, LPA observed two preschool children leaving. Upon entry, LPA observed assistant with 6 children (one infant and five preschool age) and Licensee was not home. Licensee is not operating within the ratio and capacity requirements of the license since assistant was caring for 1 infant and 7 preschool children in Licensee's absence. Licensee, Trinh Nguyen arrived at 12:55pm. This is a repeat violation in a 12 month period.

Days and hours of operation are Monday to Friday, 7:30 am to 5:30 pm. The entrance to the facility is through the left side gate. LPA observed all required posted materials near the entrance. Per Licensee, the adults that reside in the home are licensee and spouse and two minor children reside in the home.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The home has central heating/cooling and ventilation for comfort of children. Off limit areas inside the home: master bedroom, master bathroom, two bedrooms, living room, kitchen. On limit areas include playroom and one bathroom. Off limit areas outside the home: left section and right side section including storage area. Backyard is fenced and both sides of the home are gated. The outdoor space and play equipment were observed to be age appropriate. LPA observed some children's toys like tricycles, cars and sandbox lid are cracked. Licensee stated that she has not been taking the children outdoors due to the weather. LPA advised Licensee to remove items that are broken or in disrepair prior to allowing access to children. There are no bodies of water observed. LPA observed that the bathroom used by children was in operating condition. LPA observed sunscreen and diaper rash cream in the lower cabinet drawers and reminded Licensee to place these items inaccessible to children.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2025
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: NGUYEN, TRINH
FACILITY NUMBER: 434411028
VISIT DATE: 01/31/2025
NARRATIVE
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LPA observed a 2A10BC fire extinguisher in the playroom that was last serviced on 12/03/2020. LPA reminded licensee that the fire extinguisher needs to be serviced once every 12 months. Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, poisons, medications, sharp objects and other similar items were observed to be stored inaccessible to children. Licensee understands that smoking is prohibited in the home.

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.

Licensee did not have a current Child Care Facility Roster and completed one during today's inspection. Fire/disaster drill was last conducted on 11/19/2024. LPA obtained copy of children's roster.

Seven (7) children’s files were reviewed during today's inspection. Licensee does not have liability insurance for the day care and issues the Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282). Child (C3) was observed to be missing their immunization records. Licensee's did not maintain the 15 minute nap check log and LPA was only able to observe the nap log for today. LPA reminded Licensee that 15-minute nap checks need to be documented and maintained in child's file for review by Licensing.

LPA reviewed two staff files (Licensee and assistant) for the required forms and found them to be current and up to date. A review of staff records indicates that both staff have received criminal record and child abuse index clearances. Licensee and assistant have current Pediatric CPR/First Aid certification which expires on 04/09/2026. Licensee's Mandated Reporter Training expires on 09/23/2026 and assistant's expires on 09/09/2026. Licensee and staff have the required immunization in file for measles, pertussis and statement declining influenza vaccine.

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: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
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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: NGUYEN, TRINH
FACILITY NUMBER: 434411028
VISIT DATE: 01/31/2025
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. LPA discussed the requirement for 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 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.

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.

Incidental Medical Services (IMS) policy was discussed. Licensee states that she is not providing any medications 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 she does not transport any day care children. LPA informed Licensee that if she decides to transport children then 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.

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

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
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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: NGUYEN, TRINH
FACILITY NUMBER: 434411028
VISIT DATE: 01/31/2025
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, Licensee confirmed that there are no Registered Sex Offenders living in the facility.

One Type A deficiency, two Type B deficiencies were cited today on the attached LIC 809D pages. Appeal rights and LIC 9224 were printed and provided to Licensee. Civil Penalties issued.

LPA Raja informed licensee, Trinh Nguyen that this report dated 01/31/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Raja informed the licensee to provide a copy of this licensing report dated 01/31/2025 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with Licensee, Trinh Nguyen.

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: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
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Document Has Been Signed on 02/03/2025 08:30 AM - It Cannot Be Edited


Created By: Farida Raja On 01/31/2025 at 02:12 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: NGUYEN, TRINH
FACILITY NUMBER: 434411028

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

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 which poses an immediate health, safety or personal rights risk to persons in care. Upon arrival, LPA observed two preschool children leaving. Upon entry, LPA observed assistant with 6 preschool children and Licensee was not home. Licensee arrived at 12:55pm. This is a repeat violation in a 12-month period.
POC Due Date: 02/01/2025
Plan of Correction
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Licensee to submit a written plan of correction to LPA by 02/01/2025
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: 01/31/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2025


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Document Has Been Signed on 02/03/2025 08:30 AM - It Cannot Be Edited


Created By: Farida Raja On 01/31/2025 at 02:12 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: NGUYEN, TRINH
FACILITY NUMBER: 434411028

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above for one child which poses a potential health, safety or personal rights risk to persons in care. Child, C3 is missing the immunization record.
POC Due Date: 02/14/2025
Plan of Correction
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Licensee to obtain missing immunization record and submit a plan of correction to LPA by 02/14/2025.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

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 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2025
Plan of Correction
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Licensee did not have a complete roster. Licenseee completed the roster during today's inspection.
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: 01/31/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2025


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