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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412127
Report Date: 03/21/2023
Date Signed: 03/21/2023 11:49:40 AM

Document Has Been Signed on 03/21/2023 11:49 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:TRINH, HIEN & NHUTFACILITY NUMBER:
434412127
ADMINISTRATOR:TRINH, HIEN & NHUTFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 219-4437
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
03/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:39 AM
MET WITH:Hien TrinhTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA), Farida Raja and Licensing Program Manager (LPM), Gladys Kuizon, conducted an unannounced 1- year annual inspection. LPA was granted access to the home by Licensee, Hien Trinh and explained the nature of today’s inspection. LPA observed 4 adults (licensee, co-licensee and 2 staff- S3 & S4) and 5 preschool children in the home during today’s inspection. Five more preschool children arrived while inspection was conducted. Licensee was operating within the ratio and capacity requirements of her license. Days and hours of operation are Monday to Friday 8:00 am to 5:30 pm. LPA observed all required posted materials, including facility license, Emergency Disaster Plan and Notification of Parents' Rights posted behind the front door to the home. The adults that reside in the home are Licensee, co-licensee/ brother (Nhut Trinh) and licensee’s adult son (Joseph Tran) who visits occasionally. Licensee has no minor children residing 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 (408-219-4437). LPA inspected home for any health and safety hazards. Areas accessible to children were inspected to ensure that they are clean and orderly. LPA observed age-appropriate materials, toys, and play equipment in the facility. Furniture, such as tables and chairs are in good condition. The floors were free of tripping hazards with toys put away in shelves. The home has central heating/cooling and ventilation for comfort of children. The home is two story and LPA observed barricaded stairs during today's inspection. Off limit areas inside the home: entire upstairs, downstairs(kitchen, storage closet, family room/bedroom, shower/storage area) and attached garage. LPM and LPA observed that off-limits areas are barricaded. Licensee stated that the family room is now off-limits and LPA provided licensee with a copy of form LIC 999A to update the facility sketch. Off limit areas outside the home: left and right side sections of the backyard and two storage sheds. Backyard is fenced and both sides of the home are gated. LPA observed a play structure in the backyard that is safe and secure for the children. There are no bodies of water.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2023
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: TRINH, HIEN & NHUT
FACILITY NUMBER: 434412127
VISIT DATE: 03/21/2023
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LPA observed a fully charged 3A40BC fire extinguisher in the kitchen area and working smoke/carbon monoxide detectors. The Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, medications, sharp objects and other similar items are stored inaccessible to children. Licensee has a first aid kit above refrigerator and in the living room area of the home. 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 meals 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.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was conducted on 09/15/2022. LPA obtained a picture of children's roster. Children file review was completed and found to be current and up to date. Six (6) children’s files were reviewed during today's inspection for the following records: Notification of Parents Rights (LIC995A), Consent for Emergency Medical Treatment (LIC627), Identification and Emergency Information (LIC700), and Immunization Records (PM 286/CDPH 286). Licensee states that she has liability insurance through Markel which expires on 09/01/2023.

LPA discussed the safe sleep regulations with Licensee, including documentation that shall be maintained as well as conducting 15-minute checks on all sleeping infants under 2 years old. LPA discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA reviewed 4 staff files (Licensee, co-licensee and 2 assistants) and the files were complete with the required forms. Licensee has current Pediatric CPR/First Aid certification with an expiration date of 08/2023. Licensee and staff have the required vaccines (MMR, Tdap, & Influenza). Licensee's Mandated Reporter Training expires on 02/26/2024. Co-licensee does not speak English/Spanish and is therefore exempt from completing the training at this time.

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

DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023
LIC809 (FAS) - (06/04)
Page: 2 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: TRINH, HIEN & NHUT
FACILITY NUMBER: 434412127
VISIT DATE: 03/21/2023
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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. The 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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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. 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 violation within a 12 month period.

LPA discussed "zero tolerance" related regulations and advised that the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. A $500 immediate civil penalty and $100 per day violation until corrected 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.

Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov/ www.ccld.ca.gov to access resources for providers, regulations, adoptions of new laws, pay annual fees etc.

Licensee states that a child will be isolated in an area designated for the child in the living room if necessary due to illness or communicable disease. Licensee states that she does not administer any medications to the day care children at this time.

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

DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023
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: TRINH, HIEN & NHUT
FACILITY NUMBER: 434412127
VISIT DATE: 03/21/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding Americans with Disabilities Act(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: http://www.ada.gov/childqanda.htm.

The Licensee states that she does not transport any day care children. LPA reminded Licensee that if she 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.



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

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

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023
LIC809 (FAS) - (06/04)
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