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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415320
Report Date: 06/14/2024
Date Signed: 06/17/2024 08:53:06 AM

Document Has Been Signed on 06/17/2024 08:53 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:HENSEL, COMFORTFACILITY NUMBER:
434415320
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
06/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:57 AM
MET WITH:Comfort HenselTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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On 06/14/2024 at 8:57am, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced annual/random inspection. LPA was granted access to the home by Licensee, Comfort Hensel and explained the nature of today’s inspection. Present in the home were licensee and 5 preschool age children. Licensee is operating within the ratio and capacity requirements of the license. Days and hours of operation are Monday to Friday, 7:30 am to 5:30 pm. LPA observed required posted materials in the family room of the home. LPA reminded Licensee that postings need to be placed where they are visible to parents during drop off and pick up. LPA provided Licensee with a copy of the Entrance Checklist for Family Childcare Homes. The adults that reside in the home are licensee and spouse. Licensee has two minor children residing in the home. Licensee's son will turn 18 year this year and LPA reminded Licensee that he needs to be fingerprinted within 30 days once he is 18 years of age. Licensee understands that she needs to maintain fingerprint clearances and proof of tuberculosis test for all adults residing in the home. Licensee will submit an updated Application for Family Child Care Home License (LIC 279) and Current Children in Home (LIC 279B).

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (510-305-4354). LPA observed sufficient age-appropriate materials, books, manipulative toys and craft items for the day care children. Furniture, such as tables, chairs, and shelves, are in good condition. The home has central heating/cooling and ventilation for comfort of children. The home is single story. Off limit areas inside the home: master bedroom, master bath, three bedrooms, one bathroom, laundry room, attached garage. LPA observed a barricaded fireplace in the on limit family room. Off limit areas outside the home: left side section of the backyard and storage shed in the right side section. Backyard is fenced and both sides of the home are gated. LPA observed sufficient age-appropriate play structures in the backyard that are safe and secure for children. There are no bodies of water. LPA observed fertilizers, bird feed and long wood pieces in the on limit area and LPA reminded licensee that items that have splinters or pose a hazard to children need to be placed inaccessible to children.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2024
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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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: HENSEL, COMFORT
FACILITY NUMBER: 434415320
VISIT DATE: 06/14/2024
NARRATIVE
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 LPA observed that the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. LPA observed an air freshener and toilet cleaner within reach of children. LPA reminded Licensee that these items need to be placed out of reach of preschool children or made inaccessible by using child locks. LPA also observed some cleaning products on the kitchen counter within reach of children.

LPA observed a 3A40BC fire extinguisher in the garage area and working smoke/carbon monoxide detectors. LPA reminded Licensee that fire extinguishers needs to be serviced once every 12 months. Licensee states that she does not have any weapons. Licensee has one pet dog in 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 and refilled using filtered water. Licensee stated that she shares a menu with parents and provides meals (breakfast and lunch) and snacks to children in care. Parents are allowed to provide food as well. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored or refrigerated.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was last conducted on 03/04/2024.

Children file review was completed and found to be current and up to date. Five (5) children’s files were reviewed during today's inspection. Licensee carries daycare insurance and LPA observed a current policy verifying valid coverage. Licensee does not provide care to children under 2 years of age.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
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: HENSEL, COMFORT
FACILITY NUMBER: 434415320
VISIT DATE: 06/14/2024
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Licensee file review was completed and found to be current and up to date. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee has current Pediatric CPR/First Aid certification with an expiration date of 04/2025. Licensee has proof of immunization in file for measles, pertussis and statement declining influenza. Licensee's Mandated Reporter Training expires on 02/24/2025.

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.

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 8 children in the home at any time 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. The Department will communicate all new information to providers through Provider Information Notices (PINs). Please sign up to be notified for new PINs at www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and visit the Department’s website for the latest PINs.

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

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
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: HENSEL, COMFORT
FACILITY NUMBER: 434415320
VISIT DATE: 06/14/2024
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Incidental Medical Services (IMS) policy was discussed. Licensee stated that she is not administering any medications or IMS 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. 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 and LPA completed the RSO profile in FAS. 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.

One Type B deficiency was cited today on the attached LIC 809D page. Appeal rights were printed and provided to Licensee. Exit interview was conducted where report was reviewed with Licensee, Comfort Hensel.

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

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/17/2024 08:53 AM - It Cannot Be Edited


Created By: Farida Raja On 06/14/2024 at 10:59 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: HENSEL, COMFORT
FACILITY NUMBER: 434415320

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

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 above which poses a potential health, safety or personal rights risk to persons in care. LPA observed fertilizers, bird feed and long wood pieces in the on limit area outdoors, air freshener and toilet cleaner in the bathroom within reach of children and cleaning products on the kitchen counter in areas accessible to children. LPA reminded Licensee that these items needs to be placed in high cabinets, off limit areas or in child locked cabinets to prevent access by children.
POC Due Date: 06/21/2024
Plan of Correction
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Licensee to submit picture proof to LPA by plan of correction date of 06/21/2024.
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: 06/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2024


LIC809 (FAS) - (06/04)
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