434415399-11-18-2024-07-CC-LHUG-DB5MHZ-20241118083818

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415399
Report Date: 11/15/2024
Date Signed: 11/18/2024 08:38:51 AM

Document Has Been Signed on 11/18/2024 08:38 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:	MENDOZA, ALMA & CHAVEZ, MARIA		FACILITY NUMBER:	434415399
ADMINISTRATOR/ DIRECTOR:	MENDOZA, ALMA & CHAVEZ, MA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 334-5018
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95116
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 9	CENSUS: 6	DATE:	11/15/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Alma Mendoza		TIME VISIT/ INSPECTION COMPLETED:	01:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPA) Kate Huang and Farida Raja conducted an unannounced Annual inspection today and met with licensee, Alma Mendoza. 6 children are present today, including 1 infant. LPAs also met with Alma's sister, Elizabeth, who is a helper for taking care of children and their father, Raul, who lives in the property. Alma's mother, Chavez, Maria, who is another licensee, is not here today and she is in Mexico. 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. Alma stated that the operation time is from 7:30 AM to 4:15 PM. LPA observed that the temperature of the home is around 62F and the room is cold but the licensee did not open the heating. Alma stated that they cannot open the heating today because of the construction. LPAs advised Licensee to keep the room temperature comfortable for the children. Licensee placed a space heater in the room so maintain a comfortable temperature for the children. LPAs observed that Alma serving breakfast for children. Licensee said that usually children's lunch are brought from children's homes, but if someone does not bring the lunch, they will cook for them. LPAs checked the food stored in the refrigerator and the food brought from homes are not labelled. Alma said that she did not know the food need to be labelled. LPA told them that they need to label the food brought from children's homes in the future. Alma stated that there are four children living here. LPAs walked though the home with the licensee. One bathroom is still on construction, and the door of the bathroom is closed and covered during construction. LPA checked the Master Bedroom and Master Bathroom which previously was off-limit area and we received the approval for that area from fire department on 11/13/2024. LPAs observed that some toothpaste and medication are accessible to children because the drawer is not children locked. LPA remained the licensee that all shampoos, soap, medication, mouthwash, perfumes, razors, cleaning products, air fresheners, and nail polish/removers must be placed inaccessible to children. Licensee moved all items to an off limit area during today's inspection. The master bedroom and bathroom are clean and ready to use for the children.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MENDOZA, ALMA & CHAVEZ, MARIA	FACILITY NUMBER: 434415399
	VISIT DATE: 11/15/2024

NARRATIVE

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LPAs observed one crib is in the baby room. Alma stated that they always bring the crib into the living room during nap time. The infant sleeps in the living room with other children during nap time. LPAs check the kitchen and the living room and they are free from defects or conditions which might endanger a child. LPAs checked the fire extinguisher, smoke and carbon monoxide detectors and all of them work.

LPAs observed that there is no accessible body of water in the yard. LPA observed that one storage room is in the yard which is not locked. LPAs remained the licensee that the door of the storage room should be kept locked. LPA observed that they have a dog room in the yard and two dogs are there.

LPAs checked the licensee, staff and children's records and found that two licensees' mandated Reporter Training expired on 09/01/2024 and the helper does not have a mandated reporter training in her file.

Licensee Alma 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MENDOZA, ALMA & CHAVEZ, MARIA	FACILITY NUMBER: 434415399
	VISIT DATE: 11/15/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. Licensee provided Albuterol to one child if necessary. LPAs provided Licensee with PIN 22-02-CCP. Licensee to submit an Incidental Medical Plan to the Department by 11/29/2024. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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.

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.

During the exit interview, the Licensee Alma, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

As a result of today's inspection, there were one Type B deficiency cited.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee Alma Mendoza.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/18/2024 08:38 AM - It Cannot Be Edited

Created By: Linke Huang On 11/15/2024 at 12:30 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: MENDOZA, ALMA & CHAVEZ, MARIA	FACILITY NUMBER: 434415399
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day 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 every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above because two licensees' mandated reporter training certificates expired and the helper did not have mandated reporter training in her file which poses potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/29/2024
	Plan of Correction
1 2 3 4	Licensee to submit a plan of correction to have the mandated reporter training every two years by the POC due date and licensee to submit the mandated reporter training certificates for two licensees and the helper by the POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Linke Huang

LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024

LIC809 (FAS) - (06/04)

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