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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412127
Report Date: 06/07/2024
Date Signed: 06/10/2024 08:51:03 AM

Document Has Been Signed on 06/10/2024 08:51 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/
DIRECTOR:		TRINH, HIEN & NHUTFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 219-4437
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 9DATE:
06/07/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:58 AM
MET WITH:Hien TrinhTIME VISIT/
INSPECTION COMPLETED:
02:05 PM
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On 06/07/2024 at 10:58am, Licensing Program Analyst (LPA), Farida Raja conducted an unannounced annual/random inspection. LPA was granted access to the home by Licensee, Hien Trinh and explained the nature of today’s inspection. LPA observed 3 adults (licensee and 2 staff- S3 & S4) and 9 preschool children in the home during today’s inspection. 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 6:00 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). 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. Furniture, such as tables and chairs are in good condition. 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, bedroom, shower/storage area) and attached garage. Off limit areas outside the home: left and right side sections of the backyard and two locked storage sheds. Backyard is fenced and both sides of the home are gated. LPA observed a canopied area in the backyard with age appropriate furniture and toys. LPA observed a play structure in the backyard that is safe and secure for the children and has resilient materials under it to absorb falls. No bodies of water observed.

LPA observed a fully charged 3A40BC fire extinguisher in the kitchen area and working smoke/carbon monoxide detectors.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2024
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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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: 06/07/2024
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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 understands that smoking is prohibited in the home.

Drinking water is readily available for children in the home via individual water bottles. LPA observed water bottles labeled with children's names and licensee stated that bottles are refilled using water pitcher with filtered water. Licensee is part of a food program and provides meals (lunch and dinner) and morning snack 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 05/08/2024. 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 and were found contain the required forms. Licensee states that she has liability insurance through Markel which expires on 09/01/2024 and LPA verified valid coverage.

LPA reviewed 4 staff files (Licensee, co-licensee and 2 assistants) for the required forms. Licensee and co-licensee have current Pediatric CPR/First Aid certification with an expiration date of 07/30/2025 and 08/27/2025 respectively. Licensee's Mandated Reporter Training expires on 03/04/2026. Licensee stated that co-licensee and both assistants do not speak English and are unable to complete the Mandated Reporter Training. As co-licensee and assistants do not speak English/Spanish they are exempt from completing the training at this time. Co-licensee and assistants speaks Vietnamese. Licensee, co-licensee and assistants have proof of immunization's for measles, pertussis and influenza or a statement declining the influenza vaccine.

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 stated that she understands and would like to remove co-licensee from the facility license. Licensee will submit an updated Application for a Family Child Care Home License (LIC 279) to LPA. 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.

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

DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024
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: 06/07/2024
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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.

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 the dining area if necessary due to illness or communicable disease until parent pick up.

Incidental Medical Services (IMS) policy was discussed. Licensee states that she does not administer any medications/IMS to the day care children at this time. 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. LPA provided Licensee with a copy of PIN 22-02-CCP during today's inspection. 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.

Licensee states that she does not transport day care children. 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: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024
LIC809 (FAS) - (06/04)
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