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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434411410
Report Date: 05/14/2024
Date Signed: 05/15/2024 07:09:58 AM

Document Has Been Signed on 05/15/2024 07:09 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CIRCLE TIME CHILD DEVELOPMENT CENTERFACILITY NUMBER:
434411410
ADMINISTRATOR/
DIRECTOR:		TANISHA BRAMEFACILITY TYPE:
850
ADDRESS:318 EL RANCHO VERDE DRIVETELEPHONE:
(408) 538-0200
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY: 59TOTAL ENROLLED CHILDREN: 59CENSUS: 22DATE:
05/14/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Tanisha BrameTIME VISIT/
INSPECTION COMPLETED:
06:05 PM
NARRATIVE
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On 5/14/24 around 9:30am Licensing Program Analyst (LPA) Sheena Chin conducted an unannounced Case Management inspection at the facility. The director/owner, Tanisha Brame, was not in the facility. LPA met with staff and explained the purpose of the visit. Around 10am staff contacted the director about LPA’s inspection. There were 19 kids with one teacher and one aid without education work when LPA first arrived, and 3 more kids arrived at the facility, 22 children with one teacher and an aid without education work. Around 11am the director and her daughter showed up in the facility. The number of children reached to 23 with two teachers and one aid. LPA explained to the director about the purpose of the inspection. Around 11:43am one child was picked up by the mom and the number of children dropped to 22 with two teachers and one aid. The director stayed outdoor with children in care until 12pm when two other aids arrived, 22 children with one teacher and 3 aids. Around 12:15pm the director started preparing lunch.

The children were playing outdoors from 9:30 am to 12:48pm when children lined up to wash hands for lunch. Children started lunch around 1pm. LPA advised the director that the schedule posted stated that lunch time started from 11:30am to 12:15pm. During today’s inspection LPA observed trash cups were scattered and the door of the storage room was broken in the playground. LPA reviewed staff files. Only the director and S1 were qualified teachers. Other staff did not have official proofs of school works. LPA advised the director to maintain official transcripts for teacher’s qualification during the annual inspection on 3/13/24.

LPA interviewed the director, who stated that when children were sent to the doctor or ER due to major falls, the facility would submit Unusual Incident Report (UIR) to the licensing department. The director stated that she reported the UIR when one child had lip laceration last year. LPA was unable to locate the UIR the director referred in the system and the director was unable to provide a proof of the UIR submission.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE: DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2024
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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Document Has Been Signed on 05/15/2024 07:09 AM - It Cannot Be Edited


Created By: Sheena Chin On 05/14/2024 at 03:21 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: CIRCLE TIME CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434411410

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2024
Section Cited
CCR
101238(a)

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101238(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
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The director will send LPA a photo of the new shed and cleaned ground.
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Based on observation the licensee did not comply with the section cited above. LPA observed trash cups were scattered and the door of the storage room was broken in the playground, which posed a potential ealth, safety or personal rights risk to persons in care.
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Type B
05/17/2024
Section Cited
CCR101212(d)

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101212(d)…a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.
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The director will submit the UIR to the licensing office.
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Based on record review and interview LPA was unable to locate the UIR the director referred in the system and the director was unable to provide a proof of the UIR submission, which posed a potential ealth, safety or personal rights risk to persons in care.
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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:Sheena Chin
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024


LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 05/15/2024 07:09 AM - It Cannot Be Edited


Created By: Sheena Chin On 05/14/2024 at 03:33 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: CIRCLE TIME CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434411410

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/15/2024
Section Cited
CCR
101216.3(b)

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101216.3(b) The licensee may use teacher aides in a teacher-child ratio of one teacher and one aide for every 15 children in attendance.

This requirement was not met as evidenced by :
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The director will submit the required documents for qualified teachers.
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Based on observation and record review the licensee did not comply with the section cited above. 19 children with one teacher and an aid, which posed an immediate health, safety or personal rights risk to persons in care.
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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:Sheena Chin
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024


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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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CIRCLE TIME CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434411410
VISIT DATE: 05/14/2024
NARRATIVE
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Page 2.

Regulatory violations were observed during the inspection and citation were issued.

Exit interview was conducted, where this report, the citation, plan of correction, and appeal rights were reviewed and discussed with Licensee, Tanisha Brame.
Notice of Site Visit was given and must remain posted for 30 days.


LPA advised the director to print out this licensing report and deficiency report for parents to review and have parents sign LIC 9224 form. LPA advised the director that a copy of this report shall be provided to parent/guardian of any newly enrolled children for the next 12 months. LPA advised the director to post this report and the Notice of Site Visit for 30 days. Failure to maintain postings as required will result in an immediate $100 civil penalty.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC809 (FAS) - (06/04)
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