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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412028
Report Date: 09/21/2021
Date Signed: 09/21/2021 12:49:15 PM

Document Has Been Signed on 09/21/2021 12:49 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:TINY TREASURES DAYCARE & PRE. SERV. VICTORYFACILITY NUMBER:
434412028
ADMINISTRATOR:BRENDA RAMIREZFACILITY TYPE:
850
ADDRESS:590 SHAWNEE LANETELEPHONE:
(408) 578-0808
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY: 36TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
09/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Brenda RamirezTIME COMPLETED:
11:50 AM
NARRATIVE
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Licensing Program Analyst (LPA), Fermin Campos-Jaramillo made an unannounced annual required inspection to the center today. LPA met with Site Director Brenda Ramirez, and explained the nature of today's inspection to her. LPA observed 7 children were in care today. LPA observed Ms. Ramirez was taking care of the children. LPA observed that Ms. Ramirez has a current CPR/First Aid certifications expiring on 5/15/2023. LPA observed the teacher-child ratio was in compliance with regulations. LPA observed posted the forms required by this Licensing Department.

LPA toured the facility inside and outside. Staff and children's toilets and sinks are safe and in sanitary operating conditions. LPA observed the storage areas are clean and free of litter. LPA observed disinfectants, cleaning solutions, sharp objects, and other similar items are not accessible to children. LPA observed there is a first aid kit inaccessible to children. LPA observed posted a menu with the snacks provided by the center.
LPA observed the center does not have a food preparation area. Ms. Ramirez stated that children bring their own food from their homes and that the center only provides snacks. LPA observed the facility has a functioning smoke detectors and a fire extinguisher type 3A40BC last serviced on 9/16/21. LPA observed that drinking water is readily available indoor via water fountain. LPA observed there are trash cans with tight fitting covers for the disposal of solid waste. LPA observed the center has at least one working Carbon Monoxide detector.
Ms. Ramirez states that there are no weapons in the premises. Playground areas are surrounded with appropriate fencing and not bodies of water. LPA observed that all furniture, equipment and playground equipment is safe and in good conditions, free of sharp, loose, or pointed parts. LPA observed that shade in the playgrounds is provided by the building overhang. LPA observed that outdoors water is provided via water fountain. LPA observed there are enough wood chips as resilient material under the climbing structures in the playground. LPA observed all floors were clean and safe.

REPORT DATED 9/21/21 CONTINUES ON PAGE #2
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2021
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: TINY TREASURES DAYCARE & PRE. SERV. VICTORY
FACILITY NUMBER: 434412028
VISIT DATE: 09/21/2021
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Report dated 9/21/21 continues from page 1.

LPA observed that a fire drill was documented in January more than six months ago. LPA obtained a copy of the children's roster. LPA reviewed a random sample of six children's files and found in them the Identification and Emergency Information form, the Physician Report form, the Child Preadmission Health Report form, and the Parents Rights form. LPA reviewed the sign-in, sign-out sheets and are signed with full signatures. LPA observed there was a medical assessment document and a preadmission health history document in each child’s record. LPA observed there are records in each personnel file documenting the educational background of the staff.
LPA observed on the Guardian program report dated 9/20/21 that all the staff present has obtained a criminal records clearance or exemptions. LPA reminded Ms. Ramirez of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month-period.
Ms. Ramirez stated there are not children under medication currently enrolled in the center.
For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department.
LPA observed that Ms. Ramirez has not renewed the mandated reporter training AB1207 which has expired on 6/26/21. Ms. Ramirez understands the training shall be renewed every 2 years and all the adults providing care and supervision shall obtain proof of completion for the training. A referred Ms. Galvan to the Department website: www.mandatedreporterca.com for additional information on the online training. LPA observed that Ms. Ramirez has proof of immunization for measles, pertussis and influenza in file in compliance with the SB792.

There were 2 type B deficiencies cited during today's inspection.
Exit interview was conducted with Ms.Ramirez. LPA provided Ms. Ramirez with the notice of site visit which has to be visible posted for the following 30 consecutive days.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021
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Document Has Been Signed on 09/21/2021 12:49 PM - It Cannot Be Edited


Created By: Fermin Campos-Jaramillo On 09/21/2021 at 11:34 AM
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: TINY TREASURES DAYCARE & PRE. SERV. VICTORY
FACILITY NUMBER: 434412028

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/05/2021
Section Cited
CCR
101174(d)(2)

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(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year. This requirement was not met as evidenced by: The center has not documented a fire drill since January 2021. The Director understands this poses a potential risk to the children in care.
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Site Director shall conduct and document a fire drill and will submit to Licensing Department a copy of the "Fire and Disaster Log" not later than October 5, 2021.
Type B
11/05/2021
Section Cited
HSC
1596.8662(b)(1)

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training
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Ms. Ramirez shall renew the Mandated Reporter training for herself and for all the adults in the center providing care and supervision to children. Ms. Ramirez will submit a copy of the completion certificate to Licensing Department not later than November 5, 2021.
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 every two years following the date on which he or she completed the initial mandated reporter training. This requirement was not met as evidenced by: LPA observed that Site Director has not renewed the training which has expired on June 26, 2021.
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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:Mary Segura
LICENSING EVALUATOR NAME:Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2021


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